Provider Demographics
NPI:1609860857
Name:RIGALI, LESLIE JOAN (DO)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:JOAN
Last Name:RIGALI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ESSEX CENTER DRIVE
Mailing Address - Street 2:LAHEY MEDICAL CENTER, PEABODY
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-2901
Mailing Address - Country:US
Mailing Address - Phone:978-538-4300
Mailing Address - Fax:978-538-4711
Practice Address - Street 1:1 ESSEX CENTER DRIVE
Practice Address - Street 2:LAHEY MEDICAL CENTER, PEABODY
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2901
Practice Address - Country:US
Practice Address - Phone:978-538-4300
Practice Address - Fax:978-538-4711
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA81844207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
04-13110OtherEVERCARE
MA3152201Medicaid
J16616OtherBCBS MA
G26335Medicare UPIN
P00405694Medicare PIN
MAA21245Medicare ID - Type Unspecified
MA3152201Medicaid