Provider Demographics
NPI:1114987336
Name:RUGGIERO, PATRICK F (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:F
Last Name:RUGGIERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3101 SHIPPERS RD
Mailing Address - Street 2:SUITE 3101
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-2003
Mailing Address - Country:US
Mailing Address - Phone:607-770-9724
Mailing Address - Fax:607-797-7752
Practice Address - Street 1:3101 SHIPPERS RD
Practice Address - Street 2:SUITE 3101
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-2003
Practice Address - Country:US
Practice Address - Phone:607-770-9724
Practice Address - Fax:607-797-7752
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2013-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY174398-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01095225Medicaid
NY01095225Medicaid