Provider Demographics
NPI:1609389063
Name:RUTH'S SPECIAL INSTRUCTION SERVICES, INC
Entity Type:Organization
Organization Name:RUTH'S SPECIAL INSTRUCTION SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC SCHOOL SPECIAL EDUCATION
Authorized Official - Prefix:MISS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:MAXIMA
Authorized Official - Last Name:BERNARD
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:347-563-5456
Mailing Address - Street 1:346 LINDEN BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2708
Mailing Address - Country:US
Mailing Address - Phone:347-563-5456
Mailing Address - Fax:
Practice Address - Street 1:346 LINDEN BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2708
Practice Address - Country:US
Practice Address - Phone:347-563-5456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY130486030174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6538Medicaid