Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0106X | Oral and Maxillofacial Pathology | 044012 | NY |
N | 1223S0112X | Oral and Maxillofacial Surgeon | 044012 | NY |
N | 1223X0008X | Oral and Maxillofacial Radiology | 044012 | NY |
N | 1223X0400X | Orthodontists | 044012 | NY |
N | 204E00000X | Oral & Maxillofacial Surgeon | 044012 | NY |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 188732 | NY |
NPI | 1366450942 |
---|---|
Provider Name | Dr. Salvatore Louis Ruggiero |
First Address | New Hyde Park, NY 11042-1011 |
Second Address | New Hyde Park, NY 11042-1011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 13/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0117134 | AETNA (01) | NY |
01335919 | (05) | NY |
01559719 | (05) | NY |
5C4817 | HEALTHNET (01) | NY |
AS632 | OXFORD (01) | NY |
D7I151 | BC/BS (01) | NY |
U32120 | (02) | NY |