Healthcare Provider Details

I. General information

NPI: 1841589470
Provider Name (Legal Business Name): NATALIE VIGGIANO MS, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2011
Last Update Date: 04/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

279 3RD AVE
LONG BRANCH NJ
07740-6211
US

IV. Provider business mailing address

279 3RD AVE
LONG BRANCH NJ
07740-6211
US

V. Phone/Fax

Practice location:
  • Phone: 732-229-0509
  • Fax:
Mailing address:
  • Phone: 732-229-0509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number814282
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: