Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner | 624231 | NJ |
NPI | 1053758227 |
---|---|
Provider Name | Karla Ruaya |
First Address | Riverdale, NJ 07457-1715 |
Second Address | Riverdale, NJ 07457-1715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2013 |
Last Update Date | 29/05/2013 |