Provider Demographics
NPI:1760587257
Name:SCHLEIFER, RUTH ANN (MD)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:ANN
Last Name:SCHLEIFER
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 1:95 WOODLAND ST 4TH FLR
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-1230
Mailing Address - Country:US
Mailing Address - Phone:860-714-7362
Mailing Address - Fax:860-714-8140
Practice Address - Street 1:1340 SULLIVAN AVE
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074
Practice Address - Country:US
Practice Address - Phone:860-644-6676
Practice Address - Fax:860-648-9501
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT031809207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001318098Medicaid
CTD400032952Medicare PIN
CT001318098Medicaid