Provider Demographics
NPI:1477530467
Name:DIGGETT, CHARLES CHRISTOPHER (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:CHRISTOPHER
Last Name:DIGGETT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 MAIN RD STE A
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-1957
Mailing Address - Country:US
Mailing Address - Phone:631-369-4323
Mailing Address - Fax:631-369-4325
Practice Address - Street 1:189 MAIN RD STE A
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-1957
Practice Address - Country:US
Practice Address - Phone:631-369-4323
Practice Address - Fax:631-369-4325
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006819111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX48761Medicare ID - Type Unspecified
NYU61922Medicare UPIN