Provider Demographics
NPI:1700883055
Name:RUGGIERI, RICHARD JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:JOSEPH
Last Name:RUGGIERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 WAYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4304
Mailing Address - Country:US
Mailing Address - Phone:401-521-1221
Mailing Address - Fax:401-454-4189
Practice Address - Street 1:160 WAYLAND AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4304
Practice Address - Country:US
Practice Address - Phone:401-521-1221
Practice Address - Fax:401-454-4189
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI07821207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI004193OtherBLUE CHIP
404203OtherTUFTS HEALTH PLAN
RIRR31278Medicaid
RI21123OtherBCBS
0402379OtherUNITED HEALTH CARE
0407052OtherEVERCARE
AA8937OtherHARVARD PILGRIM
044OtherCIGNA
404203OtherTUFTS HEALTH PLAN
RI21123OtherBCBS