Individual
ALAN RUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
203-11 42ND AVE. #1A, BAYSIDE, NY 11361-1869
(646) 388-1459
Mailing address
203-11 42ND AVE. #1A, BAYSIDE, NY 11361-1869
(646) 388-1459
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
169338
PA
163W00000X
Registered Nurse
Primary
705674-1
NY
163W00000X
Registered Nurse
RN677278
PA
Other
Enumeration date
10/22/2015
Last updated
10/22/2015
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