Provider Demographics
NPI:1508930272
Name:ROY W. RUYMEN
Entity Type:Organization
Organization Name:ROY W. RUYMEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:W
Authorized Official - Last Name:RUYMEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD,PA
Authorized Official - Phone:201-836-4335
Mailing Address - Street 1:185 CEDAR LN
Mailing Address - Street 2:SUITE U-1
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4316
Mailing Address - Country:US
Mailing Address - Phone:201-836-4335
Mailing Address - Fax:201-836-5920
Practice Address - Street 1:185 CEDAR LN
Practice Address - Street 2:SUITE U-1
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4316
Practice Address - Country:US
Practice Address - Phone:201-836-4335
Practice Address - Fax:201-836-5920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ10855261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental