Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | N005557 | NY |
Y | 222Z00000X | Podiatrist | N005557 | NY |
NPI | 1043396757 |
---|---|
Provider Name | Ferdinand Ruiz |
First Address | Astoria, NY 11106-2217 |
Second Address | New York, NY 10029-1501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 24/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02071281 | (05) | NY |
U81524 | (02) | NY |