Provider Demographics
NPI:1770121766
Name:RUTIGLIANO, JOHN (MS)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:RUTIGLIANO
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 638
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-0638
Mailing Address - Country:US
Mailing Address - Phone:516-408-0333
Mailing Address - Fax:
Practice Address - Street 1:4 OSHEA LN
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-2956
Practice Address - Country:US
Practice Address - Phone:516-408-0333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-20
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator