Provider Demographics
NPI:1063986255
Name:JENNIFER M. RUH, MD, PC
Entity type:Organization
Organization Name:JENNIFER M. RUH, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:M
Authorized Official - Last Name:RUH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-508-4040
Mailing Address - Street 1:3725 N BUFFALO RD.
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1853
Mailing Address - Country:US
Mailing Address - Phone:716-508-4040
Mailing Address - Fax:716-508-8038
Practice Address - Street 1:3725 N BUFFALO RD.
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1853
Practice Address - Country:US
Practice Address - Phone:716-508-4040
Practice Address - Fax:716-508-8038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-22
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty