Provider Demographics
NPI:1689907057
Name:CRANSTON, RUBY (RN)
Entity Type:Individual
Prefix:
First Name:RUBY
Middle Name:
Last Name:CRANSTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11583 219TH ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIA HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11411-1140
Mailing Address - Country:US
Mailing Address - Phone:718-341-5827
Mailing Address - Fax:
Practice Address - Street 1:11583 219TH ST
Practice Address - Street 2:
Practice Address - City:CAMBRIA HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11411-1140
Practice Address - Country:US
Practice Address - Phone:718-341-5827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY444430163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY444430OtherOFFICE OF PROFESSIONS - RN LICENSE