Provider Demographics
NPI:1659330967
Name:FRIGA, RUTH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:
Last Name:FRIGA
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 1:2000 WINTON RD S
Mailing Address - Street 2:BUILDING ONE, SUITE 102
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-3970
Mailing Address - Country:US
Mailing Address - Phone:585-271-8840
Mailing Address - Fax:585-241-3094
Practice Address - Street 1:2000 WINTON RD S
Practice Address - Street 2:BUILDING ONE, SUITE 102
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-3970
Practice Address - Country:US
Practice Address - Phone:585-271-8840
Practice Address - Fax:585-241-3094
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR047121-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY103412FKOtherPREFERRED CARE
R96846Medicare UPIN
NYAA1575Medicare ID - Type Unspecified