Provider Demographics
NPI:1841482353
Name:RUTA, LINDA HECKETT (ADULT NURSE PRACTITI)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:HECKETT
Last Name:RUTA
Suffix:
Gender:F
Credentials:ADULT NURSE PRACTITI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 CLOCK TOWER CMNS
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-4055
Mailing Address - Country:US
Mailing Address - Phone:845-896-5900
Mailing Address - Fax:
Practice Address - Street 1:400 WESTAGE BUSINESS CTR DR
Practice Address - Street 2:SUITE 103
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-2223
Practice Address - Country:US
Practice Address - Phone:845-896-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY339879363LF0000X
NYF304344-1364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health