Healthcare Provider Details

I. General information

NPI: 1033288113
Provider Name (Legal Business Name): ANTHONY VIGLIOTTI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 08/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1372 STATE ROUTE 5 CHITTENANGO HEALTHCARE CENTER
CHITTENANGO NY
13037-8763
US

IV. Provider business mailing address

1372 STATE ROUTE 5 CHITTENANGO HEALTHCARE CENTER
CHITTENANGO NY
13037-8763
US

V. Phone/Fax

Practice location:
  • Phone: 315-687-5100
  • Fax: 315-687-0252
Mailing address:
  • Phone: 315-687-5100
  • Fax: 315-687-0252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number205014
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number205014
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: