Healthcare Provider Details
I. General information
NPI: 1245233436
Provider Name (Legal Business Name): DONALD J VIGLIOTTI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/23/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 NOLTE DR STE 107
KITTANNING PA
16201-7111
US
IV. Provider business mailing address
11279 PERRY HWY STE 450
WEXFORD PA
15090-9303
US
V. Phone/Fax
- Phone: 724-548-2283
- Fax: 724-543-4380
- Phone: 724-933-1100
- Fax: 724-933-1160
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | MD036888E |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: