| Marguerite Ruppenicker Llc | |
|
49 Sherwood Ter Old Saybrook CT 06475-2123 | |
| (860) 388-9882 | |
| (860) 388-9882 |
| Full Name | Marguerite Ruppenicker Llc |
|---|---|
| Speciality | Psychologist |
| Location | 49 Sherwood Ter, Old Saybrook, Connecticut |
| Authorized Official Name and Position | Marguerite R. A. Ruppenicker (MANAGING MEMBER) |
| Authorized Official Contact | 8603889882 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marguerite Ruppenicker Llc Po Box 645 Westbrook CT 06498-0645 Ph: (860) 388-9882 | Marguerite Ruppenicker Llc 49 Sherwood Ter Old Saybrook CT 06475-2123 Ph: (860) 388-9882 |
| NPI Number | 1477568806 |
|---|---|
| Provider Enumeration Date | 07/31/2006 |
| Last Update Date | 06/18/2012 |
| Medicare PECOS PAC ID | 2163705492 |
|---|---|
| Medicare Enrollment ID | O20170213001095 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477568806 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | 003193 (Connecticut) | Primary |
| Provider Name | Marguerite Ruppenicker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053760579 PECOS PAC ID: 3072896307 Enrollment ID: I20170213001528 |
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