Provider Demographics
NPI:1083708697
Name:HIGGINS, JAMES ANDREW (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ANDREW
Last Name:HIGGINS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11 CARLETON AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11730-2108
Mailing Address - Country:US
Mailing Address - Phone:631-224-7474
Mailing Address - Fax:631-224-8940
Practice Address - Street 1:11 CARLETON AVE
Practice Address - Street 2:
Practice Address - City:EAST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11730-2108
Practice Address - Country:US
Practice Address - Phone:631-224-7474
Practice Address - Fax:631-224-8940
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY206307207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY690911Medicare ID - Type Unspecified
NYF32386Medicare UPIN