Provider Demographics
NPI:1598028904
Name:VIGLIOTTI, ANNMARIE (MS, SDA)
Entity Type:Individual
Prefix:MRS
First Name:ANNMARIE
Middle Name:
Last Name:VIGLIOTTI
Suffix:
Gender:F
Credentials:MS, SDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2043 FEUEREISEN AVE
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-6410
Mailing Address - Country:US
Mailing Address - Phone:631-471-0628
Mailing Address - Fax:
Practice Address - Street 1:2043 FEUEREISEN AVE
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-6410
Practice Address - Country:US
Practice Address - Phone:631-471-0628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist