Provider Demographics
NPI:1326454968
Name:RUISI, DENISE
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:RUISI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 GROVE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778-8920
Mailing Address - Country:US
Mailing Address - Phone:631-849-2620
Mailing Address - Fax:631-473-3598
Practice Address - Street 1:27 GROVE RD
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778-8920
Practice Address - Country:US
Practice Address - Phone:631-849-2620
Practice Address - Fax:631-473-3598
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214009164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse