Provider Demographics
NPI:1891073565
Name:DSOUZA, RUTH F (LPN)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:F
Last Name:DSOUZA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 TONNELE AVENUE
Mailing Address - Street 2:APT# 4
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-5460
Mailing Address - Country:US
Mailing Address - Phone:732-766-1483
Mailing Address - Fax:
Practice Address - Street 1:92 TONNELE AVENUE
Practice Address - Street 2:APT# 4
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-5460
Practice Address - Country:US
Practice Address - Phone:732-766-1483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306237164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse