Provider Demographics
NPI:1720012917
Name:RUIZ-DELARA, MARIA CYNTHIA D (MD)
Entity Type:Individual
Prefix:
First Name:MARIA CYNTHIA
Middle Name:D
Last Name:RUIZ-DELARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 CONCORD PL
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-1728
Mailing Address - Country:US
Mailing Address - Phone:718-448-2049
Mailing Address - Fax:
Practice Address - Street 1:52 CONCORD PL
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-1728
Practice Address - Country:US
Practice Address - Phone:718-448-2049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY157592208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics