1467737353 NPI number — MRS. CAITLIN MARIE RUGGIERO DPT

Table of content: MRS. CAITLIN MARIE RUGGIERO DPT (NPI 1467737353)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467737353 NPI number — MRS. CAITLIN MARIE RUGGIERO DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUGGIERO
Provider First Name:
CAITLIN
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PISANI
Provider Other First Name:
CAITLIN
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1467737353
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/09/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
106 MILFORD ST
Provider Second Line Business Mailing Address:
SUITE 601
Provider Business Mailing Address City Name:
SALISBURY
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21804-6953
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-548-7600
Provider Business Mailing Address Fax Number:
410-548-2651

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
106 MILFORD ST
Provider Second Line Business Practice Location Address:
SUITE 601
Provider Business Practice Location Address City Name:
SALISBURY
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21804-6953
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-548-7600
Provider Business Practice Location Address Fax Number:
410-548-2651
Provider Enumeration Date:
10/11/2011

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: 225100000X , with the licence number:  24485 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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