MEDICARE: TAMMY JEANNE RUGGIERI PT, LATC, CSCS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT01398	RI

General Provider Information

NPI Number	:	1588730832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMMY JEANNE RUGGIERI PT, LATC, CSCS

Provider Business Mailing Address
First Line	:	20 SUZANNE CT
Second Line	:
City	:	WEST GREENWICH
State	:	RI
Zip	:	02817-2204
Country	:	US
Telephone Number	:	401-397-6227
Fax Number	:

Provider Business Practice Location Address
First Line	:	45 NEWPORT AVE STE C
Second Line	:
City	:	RUMFORD
State	:	RI
Zip	:	02916-2070
Country	:	US
Telephone Number	:	401-435-4540
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	07/08/2007

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