Healthcare Provider Details

I. General information

NPI: 1427314137
Provider Name (Legal Business Name): MAYLENE MAGEREENA RIGBY-HARRIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2012
Last Update Date: 04/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42-09 28TH STREET 11TH FLOOR, CN 25
LONG ISLAND CITY NY
11101
US

IV. Provider business mailing address

42-09 28TH STREET 11TH FLOOR; CN 25 GOTHAM CENTER
LONG ISLAND CITY NY
11101
US

V. Phone/Fax

Practice location:
  • Phone: 347-396-4794
  • Fax:
Mailing address:
  • Phone: 347-396-4794
  • Fax: 347-396-4767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number290595-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: