Provider Demographics
NPI:1932240470
Name:THE TRAVELER'S MEDICAL CLINIC
Entity Type:Organization
Organization Name:THE TRAVELER'S MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUGGERI-WEIGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACP
Authorized Official - Phone:908-233-1444
Mailing Address - Street 1:324 SOUTH AVE E
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-1459
Mailing Address - Country:US
Mailing Address - Phone:908-233-1444
Mailing Address - Fax:908-654-0226
Practice Address - Street 1:324 SOUTH AVE E
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-1459
Practice Address - Country:US
Practice Address - Phone:908-233-1444
Practice Address - Fax:908-654-0226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05100000207R00000X
NJ25MA04895200207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE21836Medicare UPIN
NJE55018Medicare UPIN