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NPI Code Detail

MEDICARE: MS. GERALDINE KLEINE RUCQUOI MS

MEDICARE: MS. GERALDINE KLEINE RUCQUOI MS
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
1170300000XGenetic Counselor (M.S.)

General Provider Information

NPI Number : 1558350058
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GERALDINE KLEINE RUCQUOI MS
Provider Business Mailing Address
First Line : 13 STONEGATE CIR
Second Line :
City : BRANFORD
State : CT
Zip : 06405-4314
Country : US
Telephone Number : 203-481-0160
Fax Number : 203-863-3467
Provider Business Practice Location Address
First Line : 5 PERRYRIDGE RD
Second Line : GREENWICH HOSPITAL
City : GREENWICH
State : CT
Zip : 06830-4608
Country : US
Telephone Number : 203-863-3917
Fax Number : 203-863-3467
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2005
Last Update Date : 07/08/2007

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