Provider Demographics
NPI:1841781648
Name:IAN RUGG PSYCHOLOGY PLLC
Entity Type:Organization
Organization Name:IAN RUGG PSYCHOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER; LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUGG
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:929-276-2593
Mailing Address - Street 1:545 73RD STREET
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209
Mailing Address - Country:US
Mailing Address - Phone:929-276-2593
Mailing Address - Fax:
Practice Address - Street 1:545 73RD STREET
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209
Practice Address - Country:US
Practice Address - Phone:929-276-2593
Practice Address - Fax:718-238-1405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-29
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty