Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 235624 | NY |
NPI | 1083682918 |
---|---|
Provider Name | Dr. Luke V Rigolosi |
First Address | Albany, NY 12205-1417 |
Second Address | Albany, NY 12205-1417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 30/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
107289 | (02) | NY |