Provider Demographics
NPI:1316369648
Name:SIGMONE, MARGOT MELISSA
Entity Type:Individual
Prefix:
First Name:MARGOT
Middle Name:MELISSA
Last Name:SIGMONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARGOT
Other - Middle Name:MELISSA
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:670 PARKSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-1506
Mailing Address - Country:US
Mailing Address - Phone:718-675-1249
Mailing Address - Fax:
Practice Address - Street 1:670 PARKSIDE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-1506
Practice Address - Country:US
Practice Address - Phone:718-675-1249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133530071174400000X
NY133003071174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY174400000XOther17 TEACHER