Provider Demographics
NPI:1750463113
Name:RUSKEY, ELIZABETH E (DO)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:E
Last Name:RUSKEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 593
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-0593
Mailing Address - Country:US
Mailing Address - Phone:609-967-0070
Mailing Address - Fax:
Practice Address - Street 1:336 96TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:STONE HARBOR
Practice Address - State:NJ
Practice Address - Zip Code:08247-1439
Practice Address - Country:US
Practice Address - Phone:609-967-0070
Practice Address - Fax:609-967-0077
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB59653207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ060075SBVMedicare PIN
NJF619000Medicare UPIN