Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 25ME00042100 | NJ |
NPI | 1063468320 |
---|---|
Provider Name | Kathryn A Viggiani |
First Address | Newark, NJ 07192-5378 |
Second Address | Long Branch, NJ 07740-6303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 22/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0086681 | (05) | NJ |
Q60985 | (02) | NJ |