MEDICARE: DR. JEANNE RUGGIERO RN

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	163WC0200X	Critical Care Medicine Registered Nurse	26NC06518600	NJ

General Provider Information

NPI Number	:	1922161132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEANNE RUGGIERO RN

Provider Business Mailing Address
First Line	:	1953 GRENVILLE RD
Second Line	:
City	:	SCOTCH PLAINS
State	:	NJ
Zip	:	07076-2907
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 S ORANGE AVE
Second Line	:
City	:	SOUTH ORANGE
State	:	NJ
Zip	:	07079-2646
Country	:	US
Telephone Number	:	973-761-9272
Fax Number	:

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

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	07/08/2007

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