National Provider Identifier
Gustave Theodore Ruckert V, D.O.
Gustave Theodore Ruckert V, D.O. is listed in the NPPES registry with a primary specialty of Obstetrics & Gynecology Physician in Penfield, NY and a listed phone number of (585) 641-0399.
Profile Overview
- NPI
- 1558628180
- Provider Type
- Individual
- Primary Specialty
- Obstetrics & Gynecology Physician
- Enumeration Date
- April 20, 2012
- Last Updated
- June 26, 2019
Practice Location
- 21 Willow Pond Way Ste 100
- Penfield, NY 14526-2687
Phone: (585) 641-0399
Mailing Address
- 21 Willow Pond Way
- Ste 100
- Penfield, NY 14526-2687
Specialties
- Obstetrics & Gynecology Physician (207V00000X)
Full Record
- NPI
- 1558628180
- Entity Type
- Individual
- Last Name
- Ruckert
- First Name
- Gustave
- Middle Name
- Theodore
- Name Prefix
- Dr.
- Name Suffix
- V
- Credential
- D.O.
- Mailing Street Address
- 21 Willow Pond Way
- Mailing Address Line 2
- Ste 100
- Mailing City
- Penfield
- Mailing State
- NY
- Mailing ZIP Code
- 14526-2687
- Mailing Country
- US
- Mailing Phone
- (585) 697-3201
- Mailing Fax
- (585) 641-0388
- Practice Street Address
- 21 Willow Pond Way Ste 100
- Practice City
- Penfield
- Practice State
- NY
- Practice ZIP Code
- 14526-2687
- Practice Country
- US
- Practice Phone
- (585) 641-0399
- Practice Fax
- (585) 641-0388
- Enumeration Date
- April 20, 2012
- Last Updated
- June 26, 2019
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Obstetrics & Gynecology Physician (207V00000X)