Provider Demographics
NPI:1497192108
Name:JAMES M LIGUORI PHYSICIAN PC
Entity Type:Organization
Organization Name:JAMES M LIGUORI PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:LIGUORI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-326-7839
Mailing Address - Street 1:1999 MARCUS AVE
Mailing Address - Street 2:SUITE M11
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1033
Mailing Address - Country:US
Mailing Address - Phone:516-326-7839
Mailing Address - Fax:
Practice Address - Street 1:1999 MARCUS AVE
Practice Address - Street 2:SUITE M11
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1033
Practice Address - Country:US
Practice Address - Phone:516-326-7839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY195052204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF89638Medicare UPIN