MEDICARE: DR. SAMUEL F RUGGIERO DPM

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	213E00000X	Podiatrist	N3433	NY
2	213ES0131X	Foot Surgery Podiatrist	N3433	NY

General Provider Information

NPI Number	:	1376542704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMUEL F RUGGIERO DPM

Provider Business Mailing Address
First Line	:	2507 HARLEM RD
Second Line	:
City	:	CHEEKTOWAGA
State	:	NY
Zip	:	14225-4527
Country	:	US
Telephone Number	:	716-896-6262
Fax Number	:	716-897-3338

Provider Business Practice Location Address
First Line	:	10440 MAIN ST
Second Line	:
City	:	CLARENCE
State	:	NY
Zip	:	14031-1627
Country	:	US
Telephone Number	:	716-759-6005
Fax Number	:	716-897-3338

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	11/21/2008

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