Provider Demographics
NPI:1851513253
Name:LIGNORE, JOHN SALVATORE (PA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:SALVATORE
Last Name:LIGNORE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3909 MAIN ST
Mailing Address - Street 2:MERRITT ORTHOPAEDIC ASSOCIATES
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-2815
Mailing Address - Country:US
Mailing Address - Phone:203-372-4565
Mailing Address - Fax:203-372-1585
Practice Address - Street 1:3909 MAIN ST
Practice Address - Street 2:MERRITT ORTHOPAEDIC ASSOCIATES
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-2815
Practice Address - Country:US
Practice Address - Phone:203-372-4565
Practice Address - Fax:203-372-1585
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT001334363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP83866Medicare UPIN