Individual
DR. KATHERINE F RUIZ-DE-LUZURIAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, DEPARTMENT OF PEDIATRIC IMMUNOLOGY/INFECTIOUS DISEASE, WORCESTER, MA 01655-0002
(774) 442-3947
(774) 443-8733
Mailing address
PO BOX 415348, BOSTON, MA 02241-0001
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
58569
MA
2080P0201X
Pediatric Allergy/Immunology Physician
58569
MA
2080P0208X
Pediatric Infectious Diseases Physician
Primary
58569
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110045838A
—
MA
01
—
J0747601
MEDICARE
MA
Enumeration date
12/01/2005
Last updated
08/25/2023
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