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General NPI Number Information
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NPI Number | 1215001011
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Entity Type | Individual
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Provider Name | DOUGLAS A. RIGGS RPAC
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Gender | Male
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 02/25/2010
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Provider Practice Location Address
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Address Line | 1300 ROANOKE AVE
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City | RIVERHEAD
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State | NY
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Zip | 11901-2031
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Country | US
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Telephone | 631-548-6440
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Fax |
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Provider Business Mailing Address
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Address Line | 7 FARMHOUSE DR
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City | RIDGE
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State | NY
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Zip | 11961-2169
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Country | US
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Telephone | 631-205-9626
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 006564-1
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License Number State | NY
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