Healthcare Provider Details

I. General information

NPI: 1194510230
Provider Name (Legal Business Name): ALAINA RUGGIERO OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2025
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 CHIPMAN WAY
KINGSTON MA
02364-1039
US

IV. Provider business mailing address

6 CENTER HILL RD
KINGSTON MA
02364-1549
US

V. Phone/Fax

Practice location:
  • Phone: 781-585-4100
  • Fax:
Mailing address:
  • Phone: 781-588-6069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTL9552
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: