Healthcare Provider Details

I. General information

NPI: 1477532877
Provider Name (Legal Business Name): GEORGE EDWARD RUGGI DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 SUNRISE HWY
WANTAGH NY
11793-4020
US

IV. Provider business mailing address

3200 SUNRISE HWY
WANTAGH NY
11793-4020
US

V. Phone/Fax

Practice location:
  • Phone: 516-785-6655
  • Fax: 516-785-8042
Mailing address:
  • Phone: 516-785-6655
  • Fax: 516-785-8042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberX003381-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: