Provider Demographics
NPI:1013920479
Name:RUGGIERO, CORINNE (DO)
Entity Type:Individual
Prefix:MRS
First Name:CORINNE
Middle Name:
Last Name:RUGGIERO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 GORDON DR
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1287
Mailing Address - Country:US
Mailing Address - Phone:610-363-0248
Mailing Address - Fax:610-363-4004
Practice Address - Street 1:605 GORDON DR
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1287
Practice Address - Country:US
Practice Address - Phone:610-363-0248
Practice Address - Fax:610-363-4004
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006794L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine