Healthcare Provider Details

I. General information

NPI: 1205022837
Provider Name (Legal Business Name): SOUND FAMILY MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 11/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 WOODVILLE RD
SHOREHAM NY
11786-1331
US

IV. Provider business mailing address

54 WOODVILLE RD
SHOREHAM NY
11786-1331
US

V. Phone/Fax

Practice location:
  • Phone: 631-929-1256
  • Fax: 631-929-8313
Mailing address:
  • Phone: 631-929-1256
  • Fax: 631-929-8313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: GEORGE R RUGGIERO
Title or Position: PRESIDENT
Credential: DO
Phone: 631-929-1256