George R Ruggiero (NPI# 1902828163, PAC ID# 1658285960) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY PRACTICE.
| Nation Provider ID (NPI) | 1902828163 |
| PAC ID by PECOS | 1658285960 |
| Professional Enrollment ID | I20031119000327 |
| Full Name | George R Ruggiero |
| Organization Legal Name | PECONIC BAY PRIMARY MEDICAL CARE PC |
| Address |
54 Woodville Rd Shoreham NY 11786-1331 |
| Phone Number | 6319291256 |
| Gender | M |
| Credential | MD |
| Medical School | NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY |
| Graduation Year | 1998 |
| Primary Specialty | FAMILY PRACTICE |
| Group Practice PAC ID | 7113817602 |
| Number of Group Practice Members | 50 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330107 | PECONIC BAY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 496 County Rd, Suite 111, Manorville, NY 11949-3341 | 6314053200 | PECONIC BAY PRIMARY MEDICAL CARE PC |
| 496 County Rd, Manorville, NY 11949-3341 | 6314053200 | PECONIC BAY PRIMARY MEDICAL CARE PC |
| 13400 Main Rd, Mattituck, NY 11952-3209 | 6312984008 | PECONIC BAY PRIMARY MEDICAL CARE PC |
| 54 Woodville Rd, Shoreham, NY 11786-1331 | 6319291256 | PECONIC BAY PRIMARY MEDICAL CARE PC |
| Organization Legal Name | PECONIC BAY PRIMARY MEDICAL CARE PC |
| Physicians | 49 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kenneth R Mataragas | Physician Assistant | Peconic Bay Primary Medical Care PC | 496 County Rd, Suite 111, Manorville, NY 11949-3341 |
| Victor Olujimi | Orthopedic Surgery | Peconic Bay Primary Medical Care PC | 64 Commerce Dr, Riverhaed, NY 11901 |
| Denis J Nankervis | General Surgery | Peconic Bay Primary Medical Care PC | 1267 E Main St, Riverhead, NY 11901-2676 |
| Sara A Cerrone | Internal Medicine | Peconic Bay Primary Medical Care PC | 13400 Main Rd, Mattituck, NY 11952-3209 |
| Danielle Faye Stoebe | Physician Assistant | Peconic Bay Primary Medical Care PC | 54 Woodville Rd, Shoreham, NY 11786-1331 |
| James L Earl | Nurse Practitioner | Peconic Bay Primary Medical Care PC | 32845 Main Rd, Cutchogue, NY 11935-1691 |
| Michael W Dempsey | Internal Medicine | Peconic Bay Primary Medical Care PC | 1333 Roanoke Ave, Suite 202, Riverhead, NY 11901-2029 |
| Luigi Buono | Family Medicine | Peconic Bay Primary Medical Care PC | 7905 Main Rd, Mattituck, NY 11952-1518 |
| Brian K Mcnulty | Family Medicine | Peconic Bay Primary Medical Care PC | 504 Main St B, Center Moriches, NY 11934-2232 |
| Afzal M Butt | Internal Medicine | Peconic Bay Primary Medical Care PC | 34 Commerce Dr, Riverhaed, NY 11901 |
| Street Address |
54 WOODVILLE RD |
| City | SHOREHAM |
| State | NY |
| Zip | 11786-1331 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Danielle Faye Stoebe | Physician Assistant | Peconic Bay Primary Medical Care PC | 54 Woodville Rd, Shoreham, NY 11786-1331 |
| Cynthia Carlson | Family Medicine | Peconic Bay Primary Medical Care PC | 54 Woodville Rd, Shoreham, NY 11786-1331 |
| Agostino Cervone | General Surgery | Peconic Bay Primary Medical Care PC | 54 Woodville Rd, Shoreham, NY 11786-1331 |
| Andrew Ribaudo | Physician Assistant | Peconic Bay Primary Medical Care PC | 54 Woodville Rd, Shoreham, NY 11786-1331 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Owen T Yen | Cardiovascular Disease (cardiology) | 45 Route 25a, Shoreham, NY 11786-1389 | |
| Mary Lee Hasbrouck | Clinical Social Worker | 45 Route 25a, Suite A2, Shoreham, NY 11786-1389 | |
| Jeffrey Kraushaar | Optometry | Soundview Optometry Pllc | 45 Route 25a, Suite F, Shoreham, NY 11786-1389 |
| Justin D Kraushaar | Optometry | Soundview Optometry Pllc | 45 Route 25a, Suite F, Shoreham, NY 11786-1389 |
| Diane Gavares | Clinical Social Worker | 3 Middle Cross, Shoreham, NY 11786-1441 | |
| Robert Thomas Badalian | Chiropractic | 21 Miller Ave, Shoreham, NY 11786-1803 |
| City | SHOREHAM |
| Zip Code | 11786 |
| Specialty | FAMILY PRACTICE |
| City + Specialty | SHOREHAM + FAMILY PRACTICE |
Please comment or provide details below to improve the information on George R Ruggiero.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.