MEDICARE: RICHARD A RUSCONI RN, APN

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	363L00000X	Nurse Practitioner	26NN08865000	NJ
2	363L00000X	Nurse Practitioner	26NO08865000	NJ
3	363LA2100X	Acute Care Nurse Practitioner	26NN08865000	NJ
4	363LG0600X	Gerontology Nurse Practitioner	26NN08865000	NJ

Other Identifiers

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

General Provider Information

NPI Number	:	1639391543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD A RUSCONI RN, APN

Provider Business Mailing Address
First Line	:	275 PATERSON AVE
Second Line	:	1ST FLOOR
City	:	LITTLE FALLS
State	:	NJ
Zip	:	07424-5627
Country	:	US
Telephone Number	:	973-785-3334
Fax Number	:	973-785-7760

Provider Business Practice Location Address
First Line	:	275 PATERSON AVE
Second Line	:	1ST FLOOR
City	:	LITTLE FALLS
State	:	NJ
Zip	:	07424-5627
Country	:	US
Telephone Number	:	973-785-3334
Fax Number	:	973-785-7760

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	03/17/2010

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Directions to “ RICHARD A RUSCONI RN, APN” Practice Location

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