Healthcare Provider Details

I. General information

NPI: 1578768479
Provider Name (Legal Business Name): PATRICIA RUGGIERO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 GLENWOOD AVE SUITE 204
BLOOMFIELD NJ
07003-2484
US

IV. Provider business mailing address

1067 BRIGHTON ST
UNION NJ
07083-6701
US

V. Phone/Fax

Practice location:
  • Phone: 908-347-8117
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05315900
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: