Provider Demographics
NPI:1477832228
Name:RUIZ, DORIS (LCSW)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 BOILING SPRING AVE
Mailing Address - Street 2:APT# 2
Mailing Address - City:EAST RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07073-1812
Mailing Address - Country:US
Mailing Address - Phone:201-951-1169
Mailing Address - Fax:
Practice Address - Street 1:285 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3906
Practice Address - Country:US
Practice Address - Phone:201-395-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054249001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical