Provider Demographics
NPI:1093191728
Name:RUEBENSAAL, PATRICIA SANDRA
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:SANDRA
Last Name:RUEBENSAAL
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:SANDRA
Other - Last Name:TOTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10065 ELSETTA AVE
Mailing Address - Street 2:
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3148
Mailing Address - Country:US
Mailing Address - Phone:440-503-1822
Mailing Address - Fax:
Practice Address - Street 1:10065 ELSETTA AVE
Practice Address - Street 2:
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3148
Practice Address - Country:US
Practice Address - Phone:440-503-1822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide