Provider Demographics
NPI:1225673544
Name:RUGELES SEPULVEDA, VANESSA (ND)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:
Last Name:RUGELES SEPULVEDA
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1428 SOUTH AVE APT 4G
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07062-1928
Mailing Address - Country:US
Mailing Address - Phone:908-546-0937
Mailing Address - Fax:
Practice Address - Street 1:1428 SOUTH AVE APT 4G
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07062-1928
Practice Address - Country:US
Practice Address - Phone:908-546-0937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-11
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT655175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath