Provider Demographics
NPI:1013006147
Name:BIGGER, MARY ANN
Entity Type:Individual
Prefix:
First Name:MARY ANN
Middle Name:
Last Name:BIGGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 725
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-0725
Mailing Address - Country:US
Mailing Address - Phone:607-965-8900
Mailing Address - Fax:607-965-8631
Practice Address - Street 1:2106 STATE HWY 80
Practice Address - Street 2:
Practice Address - City:EDMESTON
Practice Address - State:NY
Practice Address - Zip Code:13335
Practice Address - Country:US
Practice Address - Phone:607-965-8900
Practice Address - Fax:607-965-8631
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3316511363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS41149Medicare UPIN