Healthcare Provider Details

I. General information

NPI: 1982567640
Provider Name (Legal Business Name): ISAAC LOUIS RUGGLES ALTMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 PHILLIPS HILL RD
NEW CITY NY
10956-2018
US

IV. Provider business mailing address

16 FARMINGTON CT
RAMSEY NJ
07446-2104
US

V. Phone/Fax

Practice location:
  • Phone: 201-466-0834
  • Fax:
Mailing address:
  • Phone: 201-466-0834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR27580500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: