Provider Demographics
NPI:1154101624
Name:VIGLIANO, ERICA
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:VIGLIANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-5205
Mailing Address - Country:US
Mailing Address - Phone:203-561-1030
Mailing Address - Fax:
Practice Address - Street 1:85 4TH AVE APT 6DD
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-5215
Practice Address - Country:US
Practice Address - Phone:203-561-1030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No136A00000XDietary & Nutritional Service ProvidersDietetic Technician, Registered