Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 0622805 | NY |
NPI | 1033734355 |
---|---|
Provider Name | Ruth Alexandra Ayure-Ortiz |
First Address | Bronx, NY 10461-1407 |
Second Address | Bronx, NY 10461-1407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2020 |
Last Update Date | 11/06/2020 |