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NPI Code Detail

MEDICARE: MR. DAVID JAMES RIGO LCSW

MEDICARE: MR. DAVID JAMES RIGO LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLC10921ME

General Provider Information

NPI Number : 1376603688
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID JAMES RIGO LCSW
Provider Business Mailing Address
First Line : 17 SOUTH ST
Second Line :
City : PORTLAND
State : ME
Zip : 04101-3914
Country : US
Telephone Number : 207-408-1293
Fax Number :
Provider Business Practice Location Address
First Line : 17 SOUTH ST
Second Line :
City : PORTLAND
State : ME
Zip : 04101-3914
Country : US
Telephone Number : 207-408-1293
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 03/06/2008

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