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General NPI Number Information
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NPI Number | 1558739144
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Entity Type | Individual
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Provider Name | ANNELIESE RUGGERI
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Gender | Female
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Dates
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Enumeration Date | 09/13/2015
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Last Update Date | 09/13/2015
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Provider Practice Location Address
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Address Line | 622 W 168TH ST
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City | NEW YORK
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State | NY
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Zip | 10032-3720
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Country | US
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Telephone | 212-305-2799
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Fax |
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Provider Business Mailing Address
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Address Line | 500 GOLF RD
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City | ORANGE
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State | CT
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Zip | 06477-2118
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Country | US
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Telephone | 203-415-1218
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 039440
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License Number State | NY
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