Provider Demographics
NPI:1396184412
Name:RUGGIERO, TAMI ANN (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:TAMI
Middle Name:ANN
Last Name:RUGGIERO
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 PEACHTREE CT
Mailing Address - Street 2:
Mailing Address - City:HOLTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11742-2534
Mailing Address - Country:US
Mailing Address - Phone:631-447-2130
Mailing Address - Fax:
Practice Address - Street 1:96 CLIFF AVE
Practice Address - Street 2:
Practice Address - City:SAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11782-2308
Practice Address - Country:US
Practice Address - Phone:631-394-6672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013686-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist