Individual ProviderRuguins AndreNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2015 Grand Concourse, Bronx, NY 10453-4303(718) 299-7295(718) 618-0401PECOS EnrollmentBased on the most recent information from CMS, provider Ruguins Andre does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1225467582Provider TypeIndividualFull NameAndre, RuguinsGenderMaleSole ProprietorYesEnumeration Date11/7/2013Last Updated8/29/2019Contact InformationPractice LocationPractice Address2015 Grand Concourse, Bronx, NY 10453-4303Phone(718) 299-7295Fax(718) 299-6797Mailing LocationMailing Address3198 Grand Concourse, Bronx, NY 10458-1000Phone(718) 618-0401Fax(347) 479-1303Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseF344124New YorkCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicense672300New York