Individual
DR. JUSTIN M. RUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 VFW PKWY, BOSTON, MA 02132-4927
(857) 203-6478
Mailing address
150 S HUNTINGTON AVE, JAMAICA PLAIN, MA 02130-4817
(617) 232-9500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
276987
MA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
276987
MA
207RP1001X
Pulmonary Disease Physician
Primary
276987
MA
208000000X
Pediatrics Physician
276987
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110136684A
—
MA
05
—
3138647
—
NH
Enumeration date
05/29/2014
Last updated
04/04/2024
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