Provider Demographics
NPI:1447580014
Name:RALPH J. LAGUARDIA, M.D, P.C.
Entity Type:Organization
Organization Name:RALPH J. LAGUARDIA, M.D, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:LAGUARDIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-456-7101
Mailing Address - Street 1:10 HIGGINS HWY
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MANSFIELD CENTER
Mailing Address - State:CT
Mailing Address - Zip Code:06250-1437
Mailing Address - Country:US
Mailing Address - Phone:860-456-7101
Mailing Address - Fax:860-423-0464
Practice Address - Street 1:10 HIGGINS HWY
Practice Address - Street 2:SUITE 4
Practice Address - City:MANSFIELD CENTER
Practice Address - State:CT
Practice Address - Zip Code:06250-1437
Practice Address - Country:US
Practice Address - Phone:860-456-7101
Practice Address - Fax:860-423-0464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-05
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty