MEDICARE: ERICA VIGLIANO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	136A00000X	Registered Dietetic Technician
2	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1154101624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA VIGLIANO

Provider Business Mailing Address
First Line	:	85 4TH AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10003-5205
Country	:	US
Telephone Number	:	203-561-1030
Fax Number	:

Provider Business Practice Location Address
First Line	:	85 4TH AVE APT 6DD
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10003-5215
Country	:	US
Telephone Number	:	203-561-1030
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2023
Last Update Date	:	10/03/2023

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Directions to “ ERICA VIGLIANO ” Practice Location

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