Healthcare Provider Details

I. General information

NPI: 1578562971
Provider Name (Legal Business Name): D ANN RUGH PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANN RUGH P.T.

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 06/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 COLD SPRING RD
COXSACKIE NY
12051-2102
US

IV. Provider business mailing address

92 COLD SPRINGS RD
COXSACKIE NY
12051-2102
US

V. Phone/Fax

Practice location:
  • Phone: 518-943-6792
  • Fax: 518-943-0410
Mailing address:
  • Phone: 518-943-6792
  • Fax: 518-943-0410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number009955-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: