Provider Demographics
NPI:1427309301
Name:RUGGIERO, RALPH P (LMSW)
Entity type:Individual
Prefix:MR
First Name:RALPH
Middle Name:P
Last Name:RUGGIERO
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 SANDY LN
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-1426
Mailing Address - Country:US
Mailing Address - Phone:631-696-8373
Mailing Address - Fax:
Practice Address - Street 1:37 SANDY LN
Practice Address - Street 2:
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-1426
Practice Address - Country:US
Practice Address - Phone:631-696-8373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY720372051041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool