Healthcare Provider Details

I. General information

NPI: 1750313581
Provider Name (Legal Business Name): DAWN M RUGELIS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 01/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 LONG POND RD
ROCHESTER NY
14612-3057
US

IV. Provider business mailing address

470 LONG POND RD
ROCHESTER NY
14612-3057
US

V. Phone/Fax

Practice location:
  • Phone: 585-227-7600
  • Fax: 585-227-8322
Mailing address:
  • Phone: 585-227-7600
  • Fax: 585-227-8322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number331160
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: