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General NPI Number Information
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NPI Number | 1629769039
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Entity Type | Individual
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Provider Name | LUCILLE RUGGIERO
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Gender | Female
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Dates
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Enumeration Date | 05/17/2023
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Last Update Date | 05/17/2023
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Provider Practice Location Address
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Address Line | 4368 AMBOY RD
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City | STATEN ISLAND
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State | NY
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Zip | 10312-3820
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Country | US
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Telephone | 718-227-3049
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Fax | 718-227-3056
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Provider Business Mailing Address
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Address Line | 279 MILTON AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10306-5613
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Country | US
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Telephone | 917-807-3032
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number |
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License Number State |
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