Provider Demographics
NPI:1265717425
Name:RUEDA, JOY MICHELLE (PT)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:MICHELLE
Last Name:RUEDA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:469 FASHION AVE
Mailing Address - Street 2:SUITE 327-328
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-7605
Mailing Address - Country:US
Mailing Address - Phone:212-359-9592
Mailing Address - Fax:718-775-3419
Practice Address - Street 1:3044 CONEY ISLAND AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5660
Practice Address - Country:US
Practice Address - Phone:212-359-9592
Practice Address - Fax:718-775-3419
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY031775225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist