Provider Demographics
NPI:1144361205
Name:RADIGAN, NANCY A (DC)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:A
Last Name:RADIGAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3979 STATE HIGHWAY 30
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-6509
Mailing Address - Country:US
Mailing Address - Phone:518-883-4456
Mailing Address - Fax:518-883-6572
Practice Address - Street 1:3979 STATE HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-6509
Practice Address - Country:US
Practice Address - Phone:518-883-4456
Practice Address - Fax:518-883-6572
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005402-1111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
14-1777909OtherFED. EMPLOYER ID
T26783Medicare UPIN
14-1777909OtherFED. EMPLOYER ID