MEDICARE: DR. JOEL RIGUEUR M.D.

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	208000000X	Pediatrics Physician	185121-1	NY
2	2084P0800X	Psychiatry Physician	65206-20	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710938915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOEL RIGUEUR M.D.

Provider Business Mailing Address
First Line	:	1300 SOUTH DRIVE
Second Line	:
City	:	WINNEBAGO
State	:	WI
Zip	:	54985
Country	:	US
Telephone Number	:	920-235-4910
Fax Number	:	920-236-2937

Provider Business Practice Location Address
First Line	:	148 WILSON AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11237-3149
Country	:	US
Telephone Number	:	718-455-5500
Fax Number	:	718-455-8700

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

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	10/09/2017

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Directions to “ DR. JOEL RIGUEUR M.D.” Practice Location

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