Provider Demographics
NPI:1356376719
Name:RIGOGLIOSO, VINCENT (MD)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:
Last Name:RIGOGLIOSO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1086 TEANECK RD
Mailing Address - Street 2:SUITE 4C
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4854
Mailing Address - Country:US
Mailing Address - Phone:201-837-9449
Mailing Address - Fax:201-578-1699
Practice Address - Street 1:1086 TEANECK ROAD
Practice Address - Street 2:SUITE 4C
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4855
Practice Address - Country:US
Practice Address - Phone:201-837-9449
Practice Address - Fax:201-578-1699
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.143014207RG0100X
NJ25MA05187500207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ100005679OtherRAILROAD MEDICARE
NJ5578001Medicaid
NJE13137Medicare UPIN
NJ107071Medicare PIN