Provider Demographics
NPI:1245954650
Name:RUFFIN, GERMAINE (LMSW)
Entity type:Individual
Prefix:MR
First Name:GERMAINE
Middle Name:
Last Name:RUFFIN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 BROOK AVE
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-5640
Mailing Address - Country:US
Mailing Address - Phone:347-213-8470
Mailing Address - Fax:
Practice Address - Street 1:127 W 25TH ST FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-7207
Practice Address - Country:US
Practice Address - Phone:917-647-5949
Practice Address - Fax:212-343-8856
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY117736104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker