Provider Demographics
NPI:1134343825
Name:RUIZ, PATRICIA MARIA (RN, APN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARIA
Last Name:RUIZ
Suffix:
Gender:F
Credentials:RN, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MONTCLAIR STATE UNIVERSITY
Mailing Address - Street 2:1 NORMAL AVENUE
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-1624
Mailing Address - Country:US
Mailing Address - Phone:973-655-4361
Mailing Address - Fax:
Practice Address - Street 1:MONTCLAIR STATE UNIVERSITY
Practice Address - Street 2:1 NORMAL AVENUE
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1624
Practice Address - Country:US
Practice Address - Phone:973-655-4361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN 09961100363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics