Healthcare Provider Details

I. General information

NPI: 1225604366
Provider Name (Legal Business Name): DANIELLE SHEA RUGGIERI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2021
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 GAR HWY
SWANSEA MA
02777-3935
US

IV. Provider business mailing address

2200 GAR HWY
SWANSEA MA
02777-3935
US

V. Phone/Fax

Practice location:
  • Phone: 508-379-9605
  • Fax: 508-379-9813
Mailing address:
  • Phone: 508-379-9605
  • Fax: 508-379-9813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD19776
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1017831
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberLL86182
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: