Individual
KENNETH J RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-2500
Mailing address
177 FORT WASHINGTON AVE, NEW YORK, NY 10032-3733
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
015268
NY
Other
Enumeration date
11/03/2011
Last updated
09/17/2013
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