Provider Demographics
NPI:1659864981
Name:LIGORSKI, JACQUELINE EMMA
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:EMMA
Last Name:LIGORSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 36TH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201-1947
Mailing Address - Country:US
Mailing Address - Phone:732-604-6027
Mailing Address - Fax:
Practice Address - Street 1:5115 CENTRE AVE FL 3
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1301
Practice Address - Country:US
Practice Address - Phone:412-235-1020
Practice Address - Fax:412-235-1020
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP025719363LF0000X
PASP025629363LA2100X
OH022746363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily