Basic Information
| Provider Information | |||||||||
| NPI: | 1558350058 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RUCQUOI | ||||||||
| FirstName: | GERALDINE | ||||||||
| MiddleName: | KLEINE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13 STONEGATE CIR | ||||||||
| Address2: | |||||||||
| City: | BRANFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064054314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2034810160 | ||||||||
| FaxNumber: | 2038633467 | ||||||||
| Practice Location | |||||||||
| Address1: | 5 PERRYRIDGE RD | ||||||||
| Address2: | GREENWICH HOSPITAL | ||||||||
| City: | GREENWICH | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068304608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2038633917 | ||||||||
| FaxNumber: | 2038633467 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 170300000X | Y | Other Service Providers | Genetic Counselor, MS |
No ID Information.