Provider Demographics
NPI:1417198581
Name:VIGLIOTTI, AMY Y (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:Y
Last Name:VIGLIOTTI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E SHORE RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-2924
Mailing Address - Country:US
Mailing Address - Phone:646-535-1298
Mailing Address - Fax:
Practice Address - Street 1:333 E SHORE RD
Practice Address - Street 2:SUITE 206
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-2924
Practice Address - Country:US
Practice Address - Phone:646-535-1298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019391103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical