Healthcare Provider Details

I. General information

NPI: 1598907511
Provider Name (Legal Business Name): RUGAL ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2009
Last Update Date: 04/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3411 IRWIN AVE APT 22J
BRONX NY
10463-3744
US

IV. Provider business mailing address

PO BOX 459
NEW YORK NY
10012-0008
US

V. Phone/Fax

Practice location:
  • Phone: 917-836-4815
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MS. TAHNEE GALARZA
Title or Position: PRESIDENT
Credential: RN
Phone: 917-836-4815