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General NPI Number Information
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NPI Number | 1174836415
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Entity Type | Organization
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Legal Business Name | CARYN GARRIGA MD LLC
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Dates
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Enumeration Date | 07/15/2010
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Last Update Date | 07/15/2010
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Provider Practice Location Address
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Address Line | 249 CLARKSON RD SUITE 102
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City | ELLISVILLE
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State | MO
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Zip | 63011-2219
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Country | US
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Telephone | 636-527-8900
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Fax | 636-527-8912
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Provider Business Mailing Address
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Address Line | 249 CLARKSON RD SUITE 102
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City | ELLISVILLE
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State | MO
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Zip | 63011-2219
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Country | US
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Telephone | 636-527-8900
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Fax | 636-527-8912
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Authorized Official
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Title or Position | PEDIATRICIAN
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Name | DR. CARYN GARRIGA
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Credential | M.D.
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Telephone | 636-527-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2003014162
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License Number State | MO
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