Provider Demographics
NPI:1750313581
Name:RUGELIS, DAWN M (FNP)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:M
Last Name:RUGELIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 LONG POND RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-3057
Mailing Address - Country:US
Mailing Address - Phone:585-227-7600
Mailing Address - Fax:585-227-8322
Practice Address - Street 1:470 LONG POND RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-3057
Practice Address - Country:US
Practice Address - Phone:585-227-7600
Practice Address - Fax:585-227-8322
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY331160363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS51046Medicare UPIN
NYBB0197Medicare PIN
NYNP0444OtherPREFERRED CARE
NYP019331160OtherBLUE CHOICE