Provider Demographics
NPI:1093146276
Name:CECCHETELLI-KAMINSKY, RUTH
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:CECCHETELLI-KAMINSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:
Other - Last Name:CECCHETELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CASAC
Mailing Address - Street 1:356 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-6206
Mailing Address - Country:US
Mailing Address - Phone:845-728-4520
Mailing Address - Fax:855-662-2225
Practice Address - Street 1:367 WINDSOR HWY # 215
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-7900
Practice Address - Country:US
Practice Address - Phone:855-662-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP89157101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)