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General NPI Number Information
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NPI Number | 1841781648
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Entity Type | Organization
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Legal Business Name | IAN RUGG PSYCHOLOGY PLLC
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Dates
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Enumeration Date | 05/29/2018
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Last Update Date | 02/18/2020
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Provider Practice Location Address
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Address Line | 545 73RD STREET GROUND FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11209
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Country | US
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Telephone | 929-276-2593
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Fax | 718-238-1405
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Provider Business Mailing Address
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Address Line | 545 73RD STREET GROUND FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11209
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Country | US
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Telephone | 929-276-2593
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Fax |
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Authorized Official
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Title or Position | SOLE OWNER; LICENSED PSYCHOLOGIST
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Name | DR. IAN RUGG
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Credential | PSY.D.
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Telephone | 929-276-2593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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