Provider Demographics
NPI:1447203393
Name:RUGGIERI, EWA T (MD)
Entity Type:Individual
Prefix:
First Name:EWA
Middle Name:T
Last Name:RUGGIERI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:45 WELLS ST
Mailing Address - Street 2:STE 201
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-2927
Mailing Address - Country:US
Mailing Address - Phone:401-637-7200
Mailing Address - Fax:
Practice Address - Street 1:147 WESTBROOK RD
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:CT
Practice Address - Zip Code:06426-1512
Practice Address - Country:US
Practice Address - Phone:860-767-8265
Practice Address - Fax:860-358-8653
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD16857207R00000X
NY214806207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008063529Medicaid
NY01987939Medicaid
NY121AJ1Medicare PIN
NY01987939Medicaid