Provider Demographics
NPI:1255079422
Name:RUIZ, ADAN
Entity type:Individual
Prefix:
First Name:ADAN
Middle Name:
Last Name:RUIZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3135 CRESCENT ST APT 2G
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-3763
Mailing Address - Country:US
Mailing Address - Phone:646-530-4658
Mailing Address - Fax:
Practice Address - Street 1:333 SAW MILL RIVER RD
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-1516
Practice Address - Country:US
Practice Address - Phone:914-347-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist