Healthcare Provider Details

I. General information

NPI: 1881335206
Provider Name (Legal Business Name): ELIZABETH BIGSBY PNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2022
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 S SALINA ST
SYRACUSE NY
13202-1626
US

IV. Provider business mailing address

319 S SALINA ST
SYRACUSE NY
13202-1626
US

V. Phone/Fax

Practice location:
  • Phone: 315-420-1075
  • Fax:
Mailing address:
  • Phone: 315-420-1075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberF383559-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: