Healthcare Provider Details

I. General information

NPI: 1336173608
Provider Name (Legal Business Name): LAUREN RENEE VIGNA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN R MEIERHANS

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 10/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 ROUTE 299.
HIGHLAND NY
12528
US

IV. Provider business mailing address

222 ROUTE 299.
HIGHLAND NY
12528
US

V. Phone/Fax

Practice location:
  • Phone: 845-691-3627
  • Fax: 845-691-3641
Mailing address:
  • Phone: 845-691-3627
  • Fax: 845-691-3641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number217325
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: