Provider Demographics
NPI:1821575929
Name:RUIZ, MARIA D (APRN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:D
Last Name:RUIZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:RUIZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:233 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-4204
Mailing Address - Country:US
Mailing Address - Phone:860-224-8192
Mailing Address - Fax:
Practice Address - Street 1:233 MAIN STREET
Practice Address - Street 2:COMMUNITY MENTAL HEALTH AFFILIATES
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051
Practice Address - Country:US
Practice Address - Phone:860-224-8192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-23
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007529363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty