Provider Demographics
NPI:1366567729
Name:RUIZ, YOLANDA (MS EDCTRS)
Entity type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:MS EDCTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1549 TOWNSEND AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-6061
Mailing Address - Country:US
Mailing Address - Phone:718-470-2113
Mailing Address - Fax:
Practice Address - Street 1:1549 TOWNSEND AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-6061
Practice Address - Country:US
Practice Address - Phone:718-470-2113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist