Provider Demographics
NPI:1265845697
Name:GONZALEZ, RUTH N (CPNP)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:N
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:N
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:317 E 34TH ST FL 10
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4974
Mailing Address - Country:US
Mailing Address - Phone:212-263-6419
Mailing Address - Fax:212-263-8173
Practice Address - Street 1:317 E 34TH ST FL 10
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4974
Practice Address - Country:US
Practice Address - Phone:212-263-6419
Practice Address - Fax:212-263-8173
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY382455363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics