Provider Demographics
NPI:1831332337
Name:RIGGS, SUZANNE MARIE
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:MARIE
Last Name:RIGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14116 CRONSTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEPONSIT
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1120
Mailing Address - Country:US
Mailing Address - Phone:718-634-0312
Mailing Address - Fax:718-474-2368
Practice Address - Street 1:14116 CRONSTON AVE
Practice Address - Street 2:
Practice Address - City:NEPONSIT
Practice Address - State:NY
Practice Address - Zip Code:11694-1120
Practice Address - Country:US
Practice Address - Phone:718-634-0312
Practice Address - Fax:718-474-2368
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-13
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPENDING252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency