Provider Demographics
NPI:1215707229
Name:CUTOLO, RUBY
Entity type:Individual
Prefix:
First Name:RUBY
Middle Name:
Last Name:CUTOLO
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 1:392 CENTRAL PARK W APT 16D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5870
Mailing Address - Country:US
Mailing Address - Phone:917-225-5665
Mailing Address - Fax:
Practice Address - Street 1:392 CENTRAL PARK W APT 16D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-5870
Practice Address - Country:US
Practice Address - Phone:917-225-5665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health