Provider Demographics
NPI:1336705870
Name:RIGBY, KAILYN VERA (MD)
Entity Type:Individual
Prefix:
First Name:KAILYN
Middle Name:VERA
Last Name:RIGBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1741 FRANKFORD AVE STE 100A
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-2445
Mailing Address - Country:US
Mailing Address - Phone:215-425-2424
Mailing Address - Fax:215-425-0342
Practice Address - Street 1:1741 FRANKFORD AVE STE 110A
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-2445
Practice Address - Country:US
Practice Address - Phone:215-425-2424
Practice Address - Fax:215-425-0342
Is Sole Proprietor?:No
Enumeration Date:2019-05-09
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMD477254207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program