Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | X006961 | NY |
N | 111NR0400X | Rehabilitation Chiropractor | X-006961 | NY |
N | 111NS0005X | Chiropractic Sports Physician | X-006961 | NY |
NPI | 1194840488 |
---|---|
Provider Name | Dr. Ruth Ann Fernandez |
First Address | New York, NY 10019-8003 |
Second Address | New York, NY 10019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 16/05/2018 |