Provider Demographics
NPI:1699924787
Name:RUGGIERO-DECARLO & SHAHEM, PHYSICIANS P.C.
Entity type:Organization
Organization Name:RUGGIERO-DECARLO & SHAHEM, PHYSICIANS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PUGLIONISI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-921-5370
Mailing Address - Street 1:10031 4TH AVE
Mailing Address - Street 2:SUITE 1E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-8335
Mailing Address - Country:US
Mailing Address - Phone:718-921-5370
Mailing Address - Fax:718-921-9136
Practice Address - Street 1:10031 4TH AVE
Practice Address - Street 2:SUITE 1E
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-8335
Practice Address - Country:US
Practice Address - Phone:718-921-5370
Practice Address - Fax:718-921-9136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty