1225461932 NPI number — MRS. JENNIFER FOSHAY RUBY APRN

Table of content: MRS. JENNIFER FOSHAY RUBY APRN (NPI 1225461932)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225461932 NPI number — MRS. JENNIFER FOSHAY RUBY APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUBY
Provider First Name:
JENNIFER
Provider Middle Name:
FOSHAY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FOSHAY
Provider Other First Name:
JENNIFER
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
APRN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1225461932
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/13/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15 YORK STREET
Provider Second Line Business Mailing Address:
LMP 1080
Provider Business Mailing Address City Name:
NEW HAVEN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06510
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-737-8373
Provider Business Mailing Address Fax Number:
203-200-2235

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 YORK STREET
Provider Second Line Business Practice Location Address:
LMP 1080
Provider Business Practice Location Address City Name:
NEW HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-737-8373
Provider Business Practice Location Address Fax Number:
203-200-2235
Provider Enumeration Date:
08/16/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  005506 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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