Healthcare Provider Details

I. General information

NPI: 1023788551
Provider Name (Legal Business Name): JAMES RUDOLPH RUGGIERO DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 BELMAR PLZ
BELMAR NJ
07719-2752
US

IV. Provider business mailing address

43 E BOSWORTH BLVD
FARMINGDALE NJ
07727-4315
US

V. Phone/Fax

Practice location:
  • Phone: 732-807-4720
  • Fax:
Mailing address:
  • Phone: 732-403-6337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02039500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: