Healthcare Provider Details

I. General information

NPI: 1568475879
Provider Name (Legal Business Name): RUGGIERO ORTHOPAEDIC ASSOC LTD P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 11/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

266 LANCASTER AVE SUITE 200
MALVERN PA
19355-3256
US

IV. Provider business mailing address

266 LANCASTER AVE SUITE 200
MALVERN PA
19355
US

V. Phone/Fax

Practice location:
  • Phone: 610-644-6900
  • Fax: 610-644-7160
Mailing address:
  • Phone: 610-644-6900
  • Fax: 610-644-7160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: ROBERT A RUGGIERO
Title or Position: DOCTOR
Credential: M.D.
Phone: 610-644-6900