Provider Demographics
NPI:1194120147
Name:SIGAMONEY, TRUCLE T (PA-C)
Entity type:Individual
Prefix:MS
First Name:TRUCLE
Middle Name:T
Last Name:SIGAMONEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TRUCLE
Other - Middle Name:
Other - Last Name:TANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8827 216TH ST
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-1957
Mailing Address - Country:US
Mailing Address - Phone:646-220-3956
Mailing Address - Fax:
Practice Address - Street 1:506 6TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3609
Practice Address - Country:US
Practice Address - Phone:718-780-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-31
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018076363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04134474Medicaid
NY04134474Medicaid