Provider Demographics
NPI:1063876613
Name:FARRUGIA, RITA (MS)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:FARRUGIA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2246 79TH ST
Mailing Address - Street 2:1B
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370-2140
Mailing Address - Country:US
Mailing Address - Phone:646-620-6520
Mailing Address - Fax:
Practice Address - Street 1:2246 79TH ST
Practice Address - Street 2:1B
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11370-2140
Practice Address - Country:US
Practice Address - Phone:646-620-6520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-11
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist