Provider Demographics
NPI:1760045652
Name:KURDZIOLEK, RUTH ANN (RN)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ANN
Last Name:KURDZIOLEK
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 1:216 FIDDLERS GREEN RD
Mailing Address - Street 2:
Mailing Address - City:WEST WINFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:13491-4205
Mailing Address - Country:US
Mailing Address - Phone:315-941-6731
Mailing Address - Fax:315-624-8995
Practice Address - Street 1:216 FIDDLERS GREEN RD
Practice Address - Street 2:
Practice Address - City:WEST WINFIELD
Practice Address - State:NY
Practice Address - Zip Code:13491-4205
Practice Address - Country:US
Practice Address - Phone:315-941-6731
Practice Address - Fax:315-624-8995
Is Sole Proprietor?:No
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY595979163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health