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NPI 1083708697

NPI 1083708697 : JAMES ANDREW HIGGINS D.O. : EAST ISLIP, NY

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General NPI Number Information
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    NPI Number           |    1083708697
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    Entity Type          |    Individual 
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    Provider Name        |    JAMES ANDREW HIGGINS D.O.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/03/2006
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    Last Update Date     |    08/18/2010
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Provider Practice Location Address
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    Address Line         |    11 CARLETON AVE 
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    City                 |    EAST ISLIP
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    State                |    NY
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    Zip                  |    11730-2108
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    Country              |    US
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    Telephone            |    631-224-7474
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    Fax                  |    631-224-8940
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Provider Business Mailing Address
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    Address Line         |    11 CARLETON AVE 
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    City                 |    EAST ISLIP
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    State                |    NY
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    Zip                  |    11730-2108
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    Country              |    US
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    Telephone            |    631-224-7474
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    Fax                  |    631-224-8940
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    206307
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    License Number State |    NY
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