Provider Demographics
NPI:1659465003
Name:LIGORSKI, MARK (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:LIGORSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:72 NORTH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5648
Mailing Address - Country:US
Mailing Address - Phone:203-798-0068
Mailing Address - Fax:203-798-8859
Practice Address - Street 1:72 NORTH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5648
Practice Address - Country:US
Practice Address - Phone:203-798-0068
Practice Address - Fax:203-798-8859
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0280542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
D80760Medicare UPIN