Provider Demographics
NPI:1225461932
Name:RUBY, JENNIFER FOSHAY (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:FOSHAY
Last Name:RUBY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:FOSHAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:15 YORK STREET
Mailing Address - Street 2:LMP 1080
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510
Mailing Address - Country:US
Mailing Address - Phone:203-737-8373
Mailing Address - Fax:203-200-2235
Practice Address - Street 1:15 YORK STREET
Practice Address - Street 2:LMP 1080
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510
Practice Address - Country:US
Practice Address - Phone:203-737-8373
Practice Address - Fax:203-200-2235
Is Sole Proprietor?:No
Enumeration Date:2013-08-16
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005506363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily