Provider Demographics
NPI:1740252725
Name:RUVO, VERONICA Y (DO)
Entity type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:Y
Last Name:RUVO
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 1:17310 WRIGHT ST STE 103
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2405
Mailing Address - Country:US
Mailing Address - Phone:833-228-6889
Mailing Address - Fax:877-853-0376
Practice Address - Street 1:17310 WRIGHT ST STE 103
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2405
Practice Address - Country:US
Practice Address - Phone:833-228-6889
Practice Address - Fax:877-853-0376
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY12487C2085R0202X
ND160992085R0202X
MO20200043552085R0202X
AZ38512085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0221810OtherBCBSAZ
AZ796732Medicaid
AZ1Z7086OtherHEALTH NET OF AZ
H11298Medicare UPIN
AZZ25034Medicare PIN
AZ796732Medicaid
AZ1Z7086OtherHEALTH NET OF AZ
AZAZ0221810OtherBCBSAZ
AZP00072775Medicare PIN