Healthcare Provider Details

I. General information

NPI: 1407851892
Provider Name (Legal Business Name): COREY NYLES RIGBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 02/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 WASHINGTON ST STE 700
READING PA
19601-3463
US

IV. Provider business mailing address

501 WASHINGTON ST STE 701
READING PA
19601-3463
US

V. Phone/Fax

Practice location:
  • Phone: 610-898-0770
  • Fax: 610-898-0773
Mailing address:
  • Phone: 717-725-9903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD062211L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: