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NPI Code Detail

MEDICARE: ANTHONY MARK RUFFA DO

MEDICARE: ANTHONY MARK RUFFA DO
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
1207Q00000XFamily Medicine PhysicianOS15523FL
22084A0401XAddiction Medicine (Psychiatry & Neurology) PhysicianOS007632LPA
3207Q00000XFamily Medicine PhysicianOS007632LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134128341
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY MARK RUFFA DO
Provider Business Mailing Address
First Line : 3901 LIBERTY ST
Second Line :
City : ERIE
State : PA
Zip : 16509-1689
Country : US
Telephone Number : 814-866-5559
Fax Number : 814-864-5595
Provider Business Practice Location Address
First Line : 2625 PARADE ST
Second Line :
City : ERIE
State : PA
Zip : 16504-2809
Country : US
Telephone Number : 814-452-6383
Fax Number : 814-452-1427
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 09/05/2025

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