Provider Demographics
NPI:1275542979
Name:RUGGIERO, AMY S (RD LD)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:S
Last Name:RUGGIERO
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6601 BROCK ST
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-1610
Mailing Address - Country:US
Mailing Address - Phone:614-336-8294
Mailing Address - Fax:
Practice Address - Street 1:3363 TREMONT RD
Practice Address - Street 2:SUITE 104A
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2110
Practice Address - Country:US
Practice Address - Phone:614-451-2868
Practice Address - Fax:614-451-2868
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD5258133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic