Provider Demographics
NPI:1336401926
Name:BIGAUD, PATRICK JOHN (PA RPAC)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:JOHN
Last Name:BIGAUD
Suffix:
Gender:M
Credentials:PA RPAC
Other - Prefix:
Other - First Name:PATRICK
Other - Middle Name:JOHN
Other - Last Name:BIGAUD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPAC
Mailing Address - Street 1:48 MORRIS ST
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-4002
Mailing Address - Country:US
Mailing Address - Phone:914-815-5290
Mailing Address - Fax:914-815-5290
Practice Address - Street 1:48 MORRIS ST
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-4002
Practice Address - Country:US
Practice Address - Phone:914-815-5290
Practice Address - Fax:914-815-5290
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015612363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400080935Medicare PIN