Provider Demographics
NPI:1205022837
Name:SOUND FAMILY MEDICINE PC
Entity Type:Organization
Organization Name:SOUND FAMILY MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:R
Authorized Official - Last Name:RUGGIERO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:631-929-1256
Mailing Address - Street 1:54 WOODVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SHOREHAM
Mailing Address - State:NY
Mailing Address - Zip Code:11786-1331
Mailing Address - Country:US
Mailing Address - Phone:631-929-1256
Mailing Address - Fax:631-929-8313
Practice Address - Street 1:54 WOODVILLE RD
Practice Address - Street 2:
Practice Address - City:SHOREHAM
Practice Address - State:NY
Practice Address - Zip Code:11786-1331
Practice Address - Country:US
Practice Address - Phone:631-929-1256
Practice Address - Fax:631-929-8313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWFW411Medicare PIN