=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437114279
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN C RIGILANO MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/17/2006
-----------------------------------------------------
Last Update Date | 06/16/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3100 SCHOOLHOUSE RD
-----------------------------------------------------
City | MIDDLETOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17057-3548
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-243-1455
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 854 MC A410
-----------------------------------------------------
City | HERSHEY
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17033-0854
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-531-5995
-----------------------------------------------------
Fax | 717-531-6934
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | MD044685E
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------