Provider Demographics
NPI:1598852683
Name:RUGGIERO, JOSEPH T (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:T
Last Name:RUGGIERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 E 72ND ST OFC 300
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4635
Mailing Address - Country:US
Mailing Address - Phone:212-746-0373
Mailing Address - Fax:212-746-7481
Practice Address - Street 1:428 E 72ND ST OFC 300
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4635
Practice Address - Country:US
Practice Address - Phone:212-746-2083
Practice Address - Fax:212-746-3305
Is Sole Proprietor?:No
Enumeration Date:2006-10-09
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY135654207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00820333Medicaid
NY00820333Medicaid
NY15D431Medicare ID - Type Unspecified