Healthcare Provider Details

I. General information

NPI: 1265863930
Provider Name (Legal Business Name): NATALYA VIGLIOTTI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2013
Last Update Date: 12/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2669 BROADVIEW DR
YORKTOWN HEIGHTS NY
10598-3301
US

IV. Provider business mailing address

2669 BROADVIEW DRIVE
YORKTOWN HEIGHTS NY
10598-3308
US

V. Phone/Fax

Practice location:
  • Phone: 914-414-9053
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number618681
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberF430715
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: