Ruffalo, Thomas

Ruffalo, Thomas is an individual health care provider with primary practice located at 791 Summit Ave , Oconomowoc WI 53066-3844. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Ruffalo, Thomas can be contacted via phone (262) 569-9119.

Contact Information

Primary practice address
791 Summit Ave Oconomowoc WI 53066-3844
Phone: (262) 569-9119
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 657-023 Wisconsin

Profile Details

NPI number 1063407013
LBN Legal business name Ruffalo, Thomas
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063407013 NPPES
Wisconsin MEDICAID 42936300

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