Provider Demographics
NPI:1033734355
Name:AYURE-ORTIZ, RUTH ALEXANDRA (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ALEXANDRA
Last Name:AYURE-ORTIZ
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1832 HONE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1407
Mailing Address - Country:US
Mailing Address - Phone:917-834-4798
Mailing Address - Fax:
Practice Address - Street 1:1832 HONE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1407
Practice Address - Country:US
Practice Address - Phone:917-834-4798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0622805363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health