Provider Demographics
NPI:1194753178
Name:RUIZ, CARLOS E (MD)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:E
Last Name:RUIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:130 E 77TH ST
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-1851
Mailing Address - Country:US
Mailing Address - Phone:212-434-2606
Mailing Address - Fax:212-434-3139
Practice Address - Street 1:130 E 77TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-1851
Practice Address - Country:US
Practice Address - Phone:212-434-2606
Practice Address - Fax:212-434-2610
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2017-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY238400207RC0000X
NJ25MA09849000207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY238400OtherLICENSE