Provider Demographics
NPI:1578953410
Name:MARRUGO, ROSEMARY (MS)
Entity Type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:
Last Name:MARRUGO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 GUY LOMBARDO AVE
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-3637
Mailing Address - Country:US
Mailing Address - Phone:516-546-2822
Mailing Address - Fax:516-546-5051
Practice Address - Street 1:33 GUY LOMBARDO AVE
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-3637
Practice Address - Country:US
Practice Address - Phone:516-546-2822
Practice Address - Fax:516-546-5051
Is Sole Proprietor?:No
Enumeration Date:2015-01-30
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP81170101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health