Provider Demographics
NPI:1861592768
Name:RUFFO, JEFFREY JAMES (OD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:JAMES
Last Name:RUFFO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:55 GLEN EAGLES DR
Mailing Address - Street 2:
Mailing Address - City:WATCHUNG
Mailing Address - State:NJ
Mailing Address - Zip Code:07069-6201
Mailing Address - Country:US
Mailing Address - Phone:908-753-5896
Mailing Address - Fax:908-753-8485
Practice Address - Street 1:225 RT 22 EAST
Practice Address - Street 2:
Practice Address - City:GREEN BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08112
Practice Address - Country:US
Practice Address - Phone:732-752-6222
Practice Address - Fax:732-752-2030
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00341700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
521318Medicare ID - Type Unspecified
V28502Medicare UPIN