Provider Demographics
NPI:1841589470
Name:VIGGIANO, NATALIE (MS, RD)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:VIGGIANO
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-6211
Mailing Address - Country:US
Mailing Address - Phone:732-229-0509
Mailing Address - Fax:
Practice Address - Street 1:279 3RD AVE
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-6211
Practice Address - Country:US
Practice Address - Phone:732-229-0509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ814282133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered