Provider Demographics
NPI:1770608440
Name:BROWN-RIGGS, CONSTANCE (MSED, RD, CDE, CDN)
Entity type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:
Last Name:BROWN-RIGGS
Suffix:
Gender:F
Credentials:MSED, RD, CDE, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 VETERANS BLVD
Mailing Address - Street 2:SUITE 15
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-4944
Mailing Address - Country:US
Mailing Address - Phone:516-795-4288
Mailing Address - Fax:866-385-1158
Practice Address - Street 1:100 VETERANS BLVD
Practice Address - Street 2:SUITE 15
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-4944
Practice Address - Country:US
Practice Address - Phone:516-795-4288
Practice Address - Fax:866-385-1158
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001536-1133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY589273OtherAETNA PROVIDER NUMBER
NYAZ00258OtherMDNY
NYS00101OtherBLUE CROSS BLUE SHIELD
NYP829563OtherOXFORD PROVIDER NUMBER
NYP829563OtherOXFORD PROVIDER NUMBER