Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 38MC00664900 | NJ |
NPI | 1235308800 |
---|---|
Provider Name | Dr. Hermes Jesus Ruiz |
First Address | Elizabeth, NJ 07202-1855 |
Second Address | Elizabeth, NJ 07208-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2008 |
Last Update Date | 27/02/2008 |