1497967814 NPI number — MS. MEGAN BOYLE RIGUGA OCCUPATIONAL THERAPI

Table of content: MS. MEGAN BOYLE RIGUGA OCCUPATIONAL THERAPI (NPI 1497967814)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497967814 NPI number — MS. MEGAN BOYLE RIGUGA OCCUPATIONAL THERAPI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIGUGA
Provider First Name:
MEGAN
Provider Middle Name:
BOYLE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
OCCUPATIONAL THERAPI
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497967814
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/19/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1917 BRADY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HALETHORPE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21227-4109
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-575-6202
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14502 GREENVIEW DR
Provider Second Line Business Practice Location Address:
SUITE 406
Provider Business Practice Location Address City Name:
LAUREL
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20708-3287
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-566-5310
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  04538 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 04538 . This is a "OT LICENSE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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