1912995549 NPI number — JUDITH E RUIZ LCSW

Table of content: JUDITH E RUIZ LCSW (NPI 1912995549)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912995549 NPI number — JUDITH E RUIZ LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUIZ
Provider First Name:
JUDITH
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912995549
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/15/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
347 5TH AVE RM 1402
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10016-5034
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-505-0419
Provider Business Mailing Address Fax Number:
877-471-4540

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
347 5TH AVE RM 1402
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10016-5034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-505-0419
Provider Business Practice Location Address Fax Number:
877-471-4540
Provider Enumeration Date:
10/07/2005

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: 1041C0700X , with the licence number:  R0270261 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 01622917 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: N60651 . This is a "EMPIRE BCBS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0023737 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: R027026 . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 052616 . This is a "AETNA HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 084627 . This is a "EBCBS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0846270 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 857113 . This is a "FIRST HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 109546 . This is a "VALUE OPTIONS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 308765A . This is a "MAGNA CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5154728 . This is a "MAGELLAN HEALTH SERVICES" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0348145 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 07205 . This is a "CIGNA HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 108537 . This is a "MANAGE HEALTH NETWORK" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 69340 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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