Provider Demographics
NPI:1538616784
Name:RUGGIO, JEAN-MARIE (RN BSN)
Entity type:Individual
Prefix:
First Name:JEAN-MARIE
Middle Name:
Last Name:RUGGIO
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 W MOHAWK ST
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-2422
Mailing Address - Country:US
Mailing Address - Phone:315-000-0000
Mailing Address - Fax:
Practice Address - Street 1:122 W MOHAWK ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2422
Practice Address - Country:US
Practice Address - Phone:315-000-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY409359-1251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)