1366404527 NPI number — MRS. PATRICIA RUGGERI-WEIGEL M.D., F.A.C.P.

Table of content: MRS. PATRICIA RUGGERI-WEIGEL M.D., F.A.C.P. (NPI 1366404527)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366404527 NPI number — MRS. PATRICIA RUGGERI-WEIGEL M.D., F.A.C.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUGGERI-WEIGEL
Provider First Name:
PATRICIA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.D., F.A.C.P.
Provider Gender Code:
F

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:
1366404527
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/26/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 27128
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84127-0128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5171 S COTTONWOOD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALT LAKE CITY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84107-5704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-507-7781
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/04/2006

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: 207RI0200X , with the licence number:  25MA04895200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RI0200X , with the licence number: 13549755-1235 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 701400 . This is a "AETNA - NONPAR" identifier . This identifiers is of the category "OTHER".
  • Identifier: P2161436 . This is a "OXFORD - NONPAR" identifier . This identifiers is of the category "OTHER".
  • Identifier: F06237 . This is a "HEALTH NET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5227704 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0311317000 . This is a "AMERIHEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 91000330700 . This is a "AMERICHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0964894 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".




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