MEDICARE: MARYANNE RUGGIERO-DELLITURRI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	187234	NY

General Provider Information

NPI Number	:	1134100852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARYANNE RUGGIERO-DELLITURRI MD

Provider Business Mailing Address
First Line	:	23625 COMMERCE PARK
Second Line	:	SUITE 204
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5845
Country	:	US
Telephone Number	:	216-255-5700
Fax Number	:

Provider Business Practice Location Address
First Line	:	119 95TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-7202
Country	:	US
Telephone Number	:	718-491-2099
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	05/05/2014

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