Individual
ANDREW T RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 ROUTE 112 BLDG 4, SUITE101, PORT JEFFERSON STATI, NY 11776-1177
(317) 513-0006
Mailing address
1500 ROUTE 112, BLDG 4, PORT JEFFERSON STATION, NY 11776-8055
(631) 751-3000
(631) 509-6559
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
096124
NY
104100000X
Social Worker
Primary
096124-1
NY
104100000X
Social Worker
—
—
Other
Enumeration date
11/08/2018
Last updated
09/12/2019
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