Provider Demographics
NPI:1194082016
Name:RAGUSA, PAUL SALVATORE (DO)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:SALVATORE
Last Name:RAGUSA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:984 N BROADWAY STE 306
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1308
Mailing Address - Country:US
Mailing Address - Phone:914-369-1700
Mailing Address - Fax:914-612-7883
Practice Address - Street 1:984 N BROADWAY STE 306
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1308
Practice Address - Country:US
Practice Address - Phone:914-369-1700
Practice Address - Fax:914-612-7883
Is Sole Proprietor?:No
Enumeration Date:2012-04-17
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH83251207X00000X
NY272563207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery