Healthcare Provider Details

I. General information

NPI: 1386468460
Provider Name (Legal Business Name): ERIKA RUGGIERI PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2024
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 W 6TH ST STE 280
OSWEGO NY
13126-2551
US

IV. Provider business mailing address

140 W 6TH ST STE 280
OSWEGO NY
13126-2551
US

V. Phone/Fax

Practice location:
  • Phone: 315-349-5752
  • Fax: 315-349-5769
Mailing address:
  • Phone: 315-349-5752
  • Fax: 315-349-5769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number032924
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: