Individual
JESSICA L RUIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 WINDHAM LOOP, STATEN ISLAND, NY 10314-5959
(908) 578-3952
Mailing address
11 WINDHAM LOOP APT 2EE, STATEN ISLAND, NY 10314-5938
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
12/15/2014
Last updated
12/19/2014
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