Provider Demographics
NPI:1255501847
Name:BIGONESS, ELSPETH A (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ELSPETH
Middle Name:A
Last Name:BIGONESS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:ELSPETH
Other - Middle Name:
Other - Last Name:HOWLETT SHAPIRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 OLD SADDLE RD
Mailing Address - Street 2:
Mailing Address - City:RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:11961
Mailing Address - Country:US
Mailing Address - Phone:631-509-1974
Mailing Address - Fax:631-509-1974
Practice Address - Street 1:10 OLD SADDLE RD
Practice Address - Street 2:
Practice Address - City:RIDGE
Practice Address - State:NY
Practice Address - Zip Code:11961
Practice Address - Country:US
Practice Address - Phone:516-949-9007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-10
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY246554164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01775979Medicaid