Provider Demographics
NPI:1023471505
Name:RUITENBERG, SARAH (PT)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:RUITENBERG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 BONNIEVIEW TERR.
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446
Mailing Address - Country:US
Mailing Address - Phone:973-831-3672
Mailing Address - Fax:
Practice Address - Street 1:1 CEDAR CREST DR
Practice Address - Street 2:
Practice Address - City:POMPTON PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07444-2100
Practice Address - Country:US
Practice Address - Phone:973-831-3672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA003880002251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics