Provider Demographics
NPI:1477532877
Name:RUGGI, GEORGE EDWARD (DC)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:EDWARD
Last Name:RUGGI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 SUNRISE HWY
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-4020
Mailing Address - Country:US
Mailing Address - Phone:516-785-6655
Mailing Address - Fax:516-785-8042
Practice Address - Street 1:3200 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-4020
Practice Address - Country:US
Practice Address - Phone:516-785-6655
Practice Address - Fax:516-785-8042
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX003381-1111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP2847715OtherOXFORD
NYX1860OtherBLUE CROSS/BLUE SHIELD
NYX1860OtherBLUE CROSS/BLUE SHIELD
NYT52394Medicare UPIN