Provider Demographics
NPI:1578631313
Name:VIGLIANI, GLORIA A (MD)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:A
Last Name:VIGLIANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 WHITE OAK RD
Mailing Address - Street 2:
Mailing Address - City:WABAN
Mailing Address - State:MA
Mailing Address - Zip Code:02468-1323
Mailing Address - Country:US
Mailing Address - Phone:781-860-8300
Mailing Address - Fax:
Practice Address - Street 1:CUBIST PHARMACEUTICALS
Practice Address - Street 2:55 HAYDEN AVE
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421
Practice Address - Country:US
Practice Address - Phone:781-860-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA48572207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine