Provider Demographics
NPI:1912001058
Name:RUGGIERO ORTHOPAEDIC ASSOCIATES LTD., P.C.
Entity Type:Organization
Organization Name:RUGGIERO ORTHOPAEDIC ASSOCIATES LTD., P.C.
Other - Org Name:ADVANCED PODIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPECIALIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:R
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:610-644-6900
Mailing Address - Street 1:266 LANCASTER AVE
Mailing Address - Street 2:SUITE200
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-3256
Mailing Address - Country:US
Mailing Address - Phone:610-644-6900
Mailing Address - Fax:610-644-7160
Practice Address - Street 1:266 LANCASTER AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3256
Practice Address - Country:US
Practice Address - Phone:610-644-6900
Practice Address - Fax:610-644-7160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004466L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACC6125OtherMEDICARE RAILROAD
PAU88165Medicare PIN
PACC6125OtherMEDICARE RAILROAD
PA639494Medicare PIN