Healthcare Provider Details

I. General information

NPI: 1174854384
Provider Name (Legal Business Name): LORRAINE M RUGGIERI LMSW, ASW-G
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2010
Last Update Date: 01/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 W 81ST ST APT 9H
NEW YORK NY
10024-6014
US

IV. Provider business mailing address

51 W 81ST ST APT 9H
NEW YORK NY
10024-6014
US

V. Phone/Fax

Practice location:
  • Phone: 212-362-6500
  • Fax:
Mailing address:
  • Phone: 212-362-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number080066
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: