Individual
KRISTIN MARIE RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1010 ROUTE 112 STE 300, PORT JEFFERSON STATION, NY 11776-3386
(631) 364-9119
Mailing address
2319 MILL RD, RONKONKOMA, NY 11779-1406
(631) 848-6964
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
029974
NY
Other
Enumeration date
06/08/2023
Last updated
06/08/2023
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