Individual
ANDREA ELIZABETH RUBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
25 CHURCH ST, WILKES BARRE, PA 18765-0999
(570) 808-3558
Mailing address
523 PHOENIX ST, DURYEA, PA 18642-1451
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA064967
PA
Other
Enumeration date
11/20/2023
Last updated
11/20/2023
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