Provider Demographics
NPI:1699814939
Name:RIGNEY, CRAIG DAVID (PT)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:DAVID
Last Name:RIGNEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WEST AVE
Mailing Address - Street 2:
Mailing Address - City:LE ROY
Mailing Address - State:NY
Mailing Address - Zip Code:14482-1367
Mailing Address - Country:US
Mailing Address - Phone:315-986-1528
Mailing Address - Fax:
Practice Address - Street 1:1218 MAYBERRY PL
Practice Address - Street 2:
Practice Address - City:MACEDON
Practice Address - State:NY
Practice Address - Zip Code:14502-8773
Practice Address - Country:US
Practice Address - Phone:315-986-1528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023543-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RB4064Medicare PIN