Provider Demographics
NPI:1134311913
Name:RUGEN CHIROPRACTIC PC
Entity Type:Organization
Organization Name:RUGEN CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP TREAS
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:RUGEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:518-758-1400
Mailing Address - Street 1:1002 KINDERHOOK ST
Mailing Address - Street 2:
Mailing Address - City:VALATIE
Mailing Address - State:NY
Mailing Address - Zip Code:12184
Mailing Address - Country:US
Mailing Address - Phone:518-758-1400
Mailing Address - Fax:518-758-1438
Practice Address - Street 1:1002 KINDERHOOK ST
Practice Address - Street 2:
Practice Address - City:VALATIE
Practice Address - State:NY
Practice Address - Zip Code:12184
Practice Address - Country:US
Practice Address - Phone:518-758-1400
Practice Address - Fax:518-758-1438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX4W502Medicare PIN