=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194510230
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALAINA RUGGIERO OTR/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/10/2025
-----------------------------------------------------
Last Update Date | 04/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17 CHIPMAN WAY
-----------------------------------------------------
City | KINGSTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02364-1039
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-585-4100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6 CENTER HILL RD
-----------------------------------------------------
City | KINGSTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02364-1549
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-588-6069
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | OTL9552
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------