Healthcare Provider Details

I. General information

NPI: 1245850890
Provider Name (Legal Business Name): RUGLASS PSYCHOLOGICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2020
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 W 27TH ST STE 300
NEW YORK NY
10001-6259
US

IV. Provider business mailing address

42 MARINERS CV
EDGEWATER NJ
07020-1293
US

V. Phone/Fax

Practice location:
  • Phone: 917-407-3441
  • Fax:
Mailing address:
  • Phone: 917-407-3441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: LESIA M. RUGLASS
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PH.D.
Phone: 917-407-3441