Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | X005402-1 | NY |
NPI | 1144361205 |
---|---|
Provider Name | Dr. Nancy A Radigan |
First Address | Amsterdam, NY 12010-6509 |
Second Address | Amsterdam, NY 12010-6509 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
14-1777909 | FED. EMPLOYER ID (01) | |
T26783 | (02) |