Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 264589 | NY |
NPI | 1568606952 |
---|---|
Provider Name | Alice Marie Ruscica |
First Address | Floral Park, NY 11001-2112 |
Second Address | New York, NY 10032-1559 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2009 |
Last Update Date | 16/09/2015 |