Individual
RUTH TYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
55 PALMER AVE, BRONXVILLE, NY 10708-3403
(914) 787-1000
Mailing address
4828 TONNELLE AVE APT 1216, NORTH BERGEN, NJ 07047-2987
(973) 525-0986
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
819042
NY
363L00000X
Nurse Practitioner
Primary
432957
NY
Other
Enumeration date
03/14/2024
Last updated
04/18/2024
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