Provider Demographics
NPI:1942947734
Name:LUPARELLO-RAGUSA, VIRGINIA MARYANN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:MARYANN
Last Name:LUPARELLO-RAGUSA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:VIRGINIA
Other - Middle Name:MARYANN
Other - Last Name:LUPARELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 AVONLEE LN
Mailing Address - Street 2:
Mailing Address - City:PAWLING
Mailing Address - State:NY
Mailing Address - Zip Code:12564-2167
Mailing Address - Country:US
Mailing Address - Phone:914-879-7924
Mailing Address - Fax:
Practice Address - Street 1:6511 SPRING BROOK AVE STE 101
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-3709
Practice Address - Country:US
Practice Address - Phone:845-471-3545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-13
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY349202363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY349202OtherNEW YORK STATE OFFICE OF THE PROFESSIONS LICENSURE NUMBER