Provider Demographics
NPI:1255189932
Name:BIGGS, EVERTON CONSTANTINE (SPECIALIST)
Entity type:Individual
Prefix:MR
First Name:EVERTON
Middle Name:CONSTANTINE
Last Name:BIGGS
Suffix:
Gender:M
Credentials:SPECIALIST
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SPECIALIST
Mailing Address - Street 1:2524 YOUNG AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-5762
Mailing Address - Country:US
Mailing Address - Phone:914-320-7026
Mailing Address - Fax:
Practice Address - Street 1:2524 YOUNG AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5762
Practice Address - Country:US
Practice Address - Phone:914-320-7026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty