Provider Demographics
NPI:1811918600
Name:NIGRO, NEIL J (MD)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:J
Last Name:NIGRO
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 1:528 WASHINGTON HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05661-8973
Mailing Address - Country:US
Mailing Address - Phone:802-888-8368
Mailing Address - Fax:802-888-8203
Practice Address - Street 1:528 WASHINGTON HIGHWAY
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:VT
Practice Address - Zip Code:05661-8973
Practice Address - Country:US
Practice Address - Phone:802-888-8368
Practice Address - Fax:802-888-8203
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0010216207PE0004X
MA203869207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1008218Medicaid
TX1257Medicare PIN
H43843Medicare UPIN