Provider Demographics
NPI:1154136174
Name:RUIZ-JAFFE, NIOMI LEE
Entity type:Individual
Prefix:
First Name:NIOMI
Middle Name:LEE
Last Name:RUIZ-JAFFE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 MIRIAM DR
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-3516
Mailing Address - Country:US
Mailing Address - Phone:347-284-8925
Mailing Address - Fax:
Practice Address - Street 1:2001 ROUTE 17M
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-5241
Practice Address - Country:US
Practice Address - Phone:845-458-8661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician