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General NPI Number Information
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NPI Number | 1821074469
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Entity Type | Organization
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Legal Business Name | MAUREEN NELLIGAN MD PC
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Dates
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Enumeration Date | 12/15/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 654 MADISON AVE 6TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10021-8404
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Country | US
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Telephone | 212-486-1082
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Fax | 212-355-4244
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Provider Business Mailing Address
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Address Line | 654 MADISON AVE 6TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10021-8404
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Country | US
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Telephone | 212-486-1082
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Fax | 212-355-4244
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Authorized Official
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Title or Position | SOLE PROPRIETER
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Name | MAUREEN NELLIGAN
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Credential | MD
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Telephone | 212-486-1082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 203015
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License Number State | NY
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