Provider Demographics
NPI: | 1508832304 |
---|---|
Name: | BIGGS, CARINA (MD) |
Entity Type: | Individual |
Prefix: | |
First Name: | CARINA |
Middle Name: | |
Last Name: | BIGGS |
Suffix: | |
Gender: | F |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | BOX 1263 |
Mailing Address - Street 2: | |
Mailing Address - City: | NEW YORK |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10029-6574 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 212-241-7646 |
Mailing Address - Fax: | 212-534-4079 |
Practice Address - Street 1: | 133 SCOVILL ST STE 308 |
Practice Address - Street 2: | |
Practice Address - City: | WATERBURY |
Practice Address - State: | CT |
Practice Address - Zip Code: | 06706-1127 |
Practice Address - Country: | US |
Practice Address - Phone: | 203-709-6315 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2006-02-23 |
Last Update Date: | 2021-05-14 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 206939 | 208600000X, 2086S0102X |
CT | 38059 | 2086S0102X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2086S0102X | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | Group - Single Specialty |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NY | 02257569 | Medicaid | |
NY | 02257569 | Medicaid | |
NY | 68L022 | Medicare ID - Type Unspecified |