Provider Demographics
NPI:1083259469
Name:VIGNALI, MARY J (AGNP-C)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:J
Last Name:VIGNALI
Suffix:
Gender:
Credentials:AGNP-C
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Other - Credentials:
Mailing Address - Street 1:10 JAMES ST STE 150
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1426
Mailing Address - Country:US
Mailing Address - Phone:973-822-2000
Mailing Address - Fax:973-822-2001
Practice Address - Street 1:10 JAMES ST STE 150
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1426
Practice Address - Country:US
Practice Address - Phone:973-822-2000
Practice Address - Fax:973-822-2001
Is Sole Proprietor?:No
Enumeration Date:2019-11-09
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00979200363LA2200X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care