Provider Demographics
NPI:1033298575
Name:CHARLES BIGAJER & ROBERT S TRACER MD PLLC
Entity Type:Organization
Organization Name:CHARLES BIGAJER & ROBERT S TRACER MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:BIGAJER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-240-6385
Mailing Address - Street 1:ONE BROOKDALE PLAZA
Mailing Address - Street 2:ROOM 323 KATZ
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212
Mailing Address - Country:US
Mailing Address - Phone:718-240-6385
Mailing Address - Fax:718-240-6756
Practice Address - Street 1:ONE BROOKDALE PLAZA
Practice Address - Street 2:ROOM 323 KATZ
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212
Practice Address - Country:US
Practice Address - Phone:718-240-6385
Practice Address - Fax:718-240-6756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY124918207RG0100X
NY117410207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEQ521Medicare ID - Type Unspecified