Provider Demographics
NPI:1609890862
Name:LIGUORI, JAMES M (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:LIGUORI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 MARCUS AVE STE W85
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-2047
Mailing Address - Country:US
Mailing Address - Phone:516-326-7839
Mailing Address - Fax:516-328-2605
Practice Address - Street 1:2001 MARCUS AVE STE W85
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-2047
Practice Address - Country:US
Practice Address - Phone:516-326-7839
Practice Address - Fax:516-328-2605
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY195052204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF89638Medicare UPIN
NY54J022Medicare ID - Type Unspecified