Provider Demographics
NPI:1003915653
Name:RUIZ JUSINO, NYDIA (MSW)
Entity Type:Individual
Prefix:
First Name:NYDIA
Middle Name:
Last Name:RUIZ JUSINO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE ALDA # 1549
Mailing Address - Street 2:URB ARIZACOON CARIBE
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-622-9797
Mailing Address - Fax:787-622-9888
Practice Address - Street 1:URBANIZACION SANTA MARIA SHOPPING CENTER OFICINA #234
Practice Address - Street 2:COMMUNITY CORNERSTONE OF PUERTO RICO
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00737
Practice Address - Country:US
Practice Address - Phone:787-651-0030
Practice Address - Fax:787-651-0033
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR76181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical