Provider Demographics
NPI:1184695397
Name:RUTTGEIZER, DENISE JANUS (MD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:JANUS
Last Name:RUTTGEIZER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6 OHIO DR
Mailing Address - Street 2:NORTH SHORE PULMONARY ASSOCIATES, P.C. LSQ MEDICAL BUIL
Mailing Address - City:LAKE SUCCESS
Mailing Address - State:NY
Mailing Address - Zip Code:11042
Mailing Address - Country:US
Mailing Address - Phone:516-328-8700
Mailing Address - Fax:516-224-1540
Practice Address - Street 1:6 OHIO DR
Practice Address - Street 2:NORTH SHORE PULMONARY ASSOCIATES, P.C. LSQ MEDICAL BUIL
Practice Address - City:LAKE SUCCESS
Practice Address - State:NY
Practice Address - Zip Code:11042
Practice Address - Country:US
Practice Address - Phone:516-328-8700
Practice Address - Fax:516-224-1540
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2021-04-01
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Provider Licenses
StateLicense IDTaxonomies
NY191745207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG55619Medicare UPIN
NY16U861Medicare ID - Type Unspecified