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General NPI Number Information
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NPI Number | 1235860875
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Entity Type | Individual
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Provider Name | PHILLIP RUGGIERO DC
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Gender | Male
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Dates
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Enumeration Date | 06/23/2022
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Last Update Date | 08/20/2024
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Provider Practice Location Address
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Address Line | 49 WELLES ST STE 215
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City | GLASTONBURY
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State | CT
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Zip | 06033-4205
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Country | US
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Telephone | 860-966-8791
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Fax |
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Provider Business Mailing Address
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Address Line | 2016 HEBRON AVE
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City | GLASTONBURY
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State | CT
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Zip | 06033-2636
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Country | US
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Telephone | 732-977-4733
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 002257
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2257
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License Number State | CT
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