1477622959 NPI number — MONICA RUEHLI MD

Table of content: MONICA RUEHLI MD (NPI 1477622959)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477622959 NPI number — MONICA RUEHLI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUEHLI
Provider First Name:
MONICA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1477622959
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/26/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1177 PROVIDENCE HIGHWAY
Provider Second Line Business Mailing Address:
PROVIDER ENROLLMENT 9TH FLOOR
Provider Business Mailing Address City Name:
NORWOOD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02062
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-431-5429
Provider Business Mailing Address Fax Number:
781-278-5575

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1177 PROVIDENCE HIGHWAY
Provider Second Line Business Practice Location Address:
PROVIDER ENROLLMENT 9TH FLOOR
Provider Business Practice Location Address City Name:
NORWOOD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02062
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-431-5429
Provider Business Practice Location Address Fax Number:
781-278-5575
Provider Enumeration Date:
11/07/2006

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: 207V00000X , with the licence number:  155364 , 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: 0020718 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2431591 . This is a "CIGNA HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J21211 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: AA45245 . This is a "HARVARD PILGRIM HEALTH CA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 155346 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 3195295 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




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