Provider Demographics
NPI:1497019186
Name:VIGOA, PATRICIA (MS ED)
Entity Type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:
Last Name:VIGOA
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 TUTTLE AVE
Mailing Address - Street 2:
Mailing Address - City:EASTPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11941-1307
Mailing Address - Country:US
Mailing Address - Phone:631-745-9736
Mailing Address - Fax:
Practice Address - Street 1:50 TUTTLE AVE
Practice Address - Street 2:
Practice Address - City:EASTPORT
Practice Address - State:NY
Practice Address - Zip Code:11941-1307
Practice Address - Country:US
Practice Address - Phone:631-745-9736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist