Provider Demographics
NPI:1245593912
Name:NANCY A RADIGAN DC PC
Entity Type:Organization
Organization Name:NANCY A RADIGAN DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RADIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:518-883-4456
Mailing Address - Street 1:3979 STATE HIGHWAY 30
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-6509
Mailing Address - Country:US
Mailing Address - Phone:518-883-4456
Mailing Address - Fax:518-883-6572
Practice Address - Street 1:3979 STATE HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-6509
Practice Address - Country:US
Practice Address - Phone:518-883-4456
Practice Address - Fax:518-883-6572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005402-1111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty