MEDICARE: ANTHONY RAGUSA MD

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	207R00000X	Internal Medicine Physician	NY200136	NY
2	207R00000X	Internal Medicine Physician	200136	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110141246	OTHER		MEDICARE RR

Other Identifiers

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

General Provider Information

NPI Number	:	1962470229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY RAGUSA MD

Provider Business Mailing Address
First Line	:	1401 STONE RD
Second Line	:	SUITE 200
City	:	ROCHESTER
State	:	NY
Zip	:	14615
Country	:	US
Telephone Number	:	585-672-4700
Fax Number	:	585-672-4700

Provider Business Practice Location Address
First Line	:	1401 STONE RD
Second Line	:	SUITE 200
City	:	ROCHESTER
State	:	NY
Zip	:	14615
Country	:	US
Telephone Number	:	585-672-4700
Fax Number	:	585-672-4700

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

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	01/09/2022

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Directions to “ ANTHONY RAGUSA MD” Practice Location

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