Provider Demographics
NPI:1225524804
Name:RUGGIERO, SALVATORE A JR (RPH)
Entity Type:Individual
Prefix:
First Name:SALVATORE
Middle Name:A
Last Name:RUGGIERO
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 LAKE AVENUE EXT
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-5244
Mailing Address - Country:US
Mailing Address - Phone:203-797-8476
Mailing Address - Fax:203-797-0289
Practice Address - Street 1:44 LAKE AVENUE EXT
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-5244
Practice Address - Country:US
Practice Address - Phone:203-797-8476
Practice Address - Fax:203-797-0289
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8372183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist