Basic Information
| Provider Information | |||||||||
| NPI: | 1982677977 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RIGGALL | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | O. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 699 E STATE ST | ||||||||
| Address2: | |||||||||
| City: | SHARON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 161462057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249833820 | ||||||||
| FaxNumber: | 7249833941 | ||||||||
| Practice Location | |||||||||
| Address1: | 2375 GARDEN WAY | ||||||||
| Address2: | |||||||||
| City: | HERMITAGE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 161485209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249835454 | ||||||||
| FaxNumber: | 7249835465 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2006 | ||||||||
| LastUpdateDate: | 12/09/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | MD043159E | PA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0804X | MD043159E | PA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 000562618 | 01 | PA | HIGHMARK | OTHER | 017713610001 | 05 | PA | MEDICAID |