Healthcare Provider Details

I. General information

NPI: 1518469865
Provider Name (Legal Business Name): JULIANNA MARIA RUGGIERO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2018
Last Update Date: 03/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2090 ADAM CLAYTON POWELL JR BLVD FL 4
NEW YORK NY
10027-4941
US

IV. Provider business mailing address

1309 5TH AVE APT 2H
NEW YORK NY
10029-3145
US

V. Phone/Fax

Practice location:
  • Phone: 212-553-6300
  • Fax:
Mailing address:
  • Phone: 631-553-5902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number735310
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: