Provider Demographics
NPI:1386468460
Name:RUGGIERI, ERIKA (PA)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:RUGGIERI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 W 6TH ST STE 280
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-2551
Mailing Address - Country:US
Mailing Address - Phone:315-349-5752
Mailing Address - Fax:315-349-5769
Practice Address - Street 1:140 W 6TH ST STE 280
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2551
Practice Address - Country:US
Practice Address - Phone:315-349-5752
Practice Address - Fax:315-349-5769
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032924363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical