Healthcare Provider Details

I. General information

NPI: 1811915036
Provider Name (Legal Business Name): JOHN ROBERT VIGNA PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 09/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 ALLEGHENY RIVER BLVD SUITE 210
OAKMONT PA
15139-1655
US

IV. Provider business mailing address

508 ALLEGHENY RIVER BLVD SUITE 210
OAKMONT PA
15139-1655
US

V. Phone/Fax

Practice location:
  • Phone: 412-826-9151
  • Fax: 412-826-9112
Mailing address:
  • Phone: 412-826-9151
  • Fax: 412-826-9112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS-006182-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: