Provider Demographics
NPI:1669851119
Name:KRAVIT, RUTH
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:KRAVIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 MARKET DR
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-6917
Mailing Address - Country:US
Mailing Address - Phone:516-776-5619
Mailing Address - Fax:
Practice Address - Street 1:21 MARKET DR
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-6917
Practice Address - Country:US
Practice Address - Phone:516-776-5619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist