1225065113 NPI number — PAUL A RUGGIERI MD

Table of content: PAUL A RUGGIERI MD (NPI 1225065113)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225065113 NPI number — PAUL A RUGGIERI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUGGIERI
Provider First Name:
PAUL
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225065113
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/26/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1030 PRESIDENT AVE
Provider Second Line Business Mailing Address:
SUITE 3002
Provider Business Mailing Address City Name:
FALL RIVER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02720-5923
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-676-3411
Provider Business Mailing Address Fax Number:
508-676-0932

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1030 PRESIDENT AVE
Provider Second Line Business Practice Location Address:
SUITE 3002
Provider Business Practice Location Address City Name:
FALL RIVER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02720-5923
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-676-3411
Provider Business Practice Location Address Fax Number:
508-676-0932
Provider Enumeration Date:
06/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  MA158145 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0027848 . This is a "NHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1700566 . This is a "UHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9461208 002 . This is a "CIGNA FOR REFERRALS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 020045787 . This is a "RAILROAD MED" identifier . This identifiers is of the category "OTHER".
  • Identifier: PR28496 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 020045787 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 807888 . This is a "HPHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000369 . This is a "SWH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2093283 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3189392 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: B20914802 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: J19613 . This is a "MASS BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000021263 . This is a "BMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 158145 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 403436 . This is a "BLUE CHIP" identifier . This identifiers is of the category "OTHER".
  • Identifier: J19613 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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