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Individual

KIRSTEN A. RUHL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
249 FRANKLIN AVE, NUTLEY, NJ 07110-2115
(845) 342-4774
(845) 343-8741
Mailing address
111 MALTESE DR, MIDDLETOWN, NY 10940-2115
(845) 342-4774
(845) 343-8741

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
017609
NY
363A00000X
Physician Assistant
Primary
25MP00348900
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
017609
NYS LICENSE
NY
Enumeration date
06/26/2014
Last updated
07/05/2019
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