Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 210396-1 | NY |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 210396-1 | NY |
N | 207XS0106X | Orthopaedic Hand Surgeon | MA-61400 | NJ |
NPI | 1336130673 |
---|---|
Provider Name | Dr. Vincent Ruggiero |
First Address | Staten Island, NY 10309-1207 |
Second Address | Staten Island, NY 10306-3608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2005 |
Last Update Date | 20/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01990716 | (05) | NY |
G91318 | (02) |