Provider Demographics
NPI:1700839875
Name:RUGGIERO, RALPH (MD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:
Last Name:RUGGIERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5610 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-3599
Mailing Address - Country:US
Mailing Address - Phone:718-630-7617
Mailing Address - Fax:718-630-6878
Practice Address - Street 1:5610 2ND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-3599
Practice Address - Country:US
Practice Address - Phone:718-630-7617
Practice Address - Fax:718-630-6878
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY144139207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA60845Medicare UPIN