Provider Demographics
NPI:1558301333
Name:RUELAS, VERONICA (OD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:
Last Name:RUELAS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 W 16TH ST
Mailing Address - Street 2:LOFT 9B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6322
Mailing Address - Country:US
Mailing Address - Phone:917-887-8828
Mailing Address - Fax:
Practice Address - Street 1:220 MURRAY ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10282-5600
Practice Address - Country:US
Practice Address - Phone:212-227-0360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005969152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist