Provider Demographics
NPI:1104196013
Name:RAINONE, RUTH ANN (RN)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:ANN
Last Name:RAINONE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:MCELHENNY
Other - Last Name:RAINONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:170 MASTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:MASTIC
Mailing Address - State:NY
Mailing Address - Zip Code:11950-3317
Mailing Address - Country:US
Mailing Address - Phone:631-399-5647
Mailing Address - Fax:
Practice Address - Street 1:170 MASTIC BLVD
Practice Address - Street 2:
Practice Address - City:MASTIC
Practice Address - State:NY
Practice Address - Zip Code:11950
Practice Address - Country:US
Practice Address - Phone:631-399-5647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-09
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY706179163W00000X
NY296745164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse