Healthcare Provider Details

I. General information

NPI: 1346562386
Provider Name (Legal Business Name): CHARLENE NEUMANN RUGGERIO PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2010
Last Update Date: 08/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 FISHER AVE
TUCKAHOE NY
10707-2604
US

IV. Provider business mailing address

6 FISHER AVE
TUCKAHOE NY
10707-2604
US

V. Phone/Fax

Practice location:
  • Phone: 914-395-1234
  • Fax: 914-395-0974
Mailing address:
  • Phone: 914-395-1234
  • Fax: 914-395-0974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1051929
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: