Provider Demographics
NPI:1821017237
Name:RUIZ, VERONICA J (MD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:J
Last Name:RUIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:301 PROSPECT AVE
Mailing Address - Street 2:HOSPITAL INTERNISTS
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-1807
Mailing Address - Country:US
Mailing Address - Phone:315-448-5704
Mailing Address - Fax:315-423-6853
Practice Address - Street 1:301 PROSPECT AVE
Practice Address - Street 2:HOSPITAL INTERNISTS
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-1807
Practice Address - Country:US
Practice Address - Phone:315-448-5704
Practice Address - Fax:315-423-6853
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY161854-1207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01401234Medicaid
RA2733Medicare PIN
NYF57006Medicare UPIN
NY01401234Medicaid