Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 1295093763 | MA |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 294454 | NY |
NPI | 1295093763 |
---|---|
Provider Name | Cassandra Riggs |
First Address | E. Syracuse, NY 13057 |
Second Address | Syracuse, NY 13214 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2012 |
Last Update Date | 26/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05247296 | (05) | NY |