Provider Demographics
NPI:1629585344
Name:ARANDA, RUY (PSYD, JD)
Entity Type:Individual
Prefix:
First Name:RUY
Middle Name:
Last Name:ARANDA
Suffix:
Gender:M
Credentials:PSYD, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 43RD AVE
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-5154
Mailing Address - Country:US
Mailing Address - Phone:718-457-3715
Mailing Address - Fax:718-457-1100
Practice Address - Street 1:6801 43RD AVE
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-5154
Practice Address - Country:US
Practice Address - Phone:718-457-3715
Practice Address - Fax:718-457-1100
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007521103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic