Provider Demographics
NPI:1306263512
Name:ALEXANDER, RUTH (NP)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 BROADWAY
Mailing Address - Street 2:SUITE 1018
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4709
Mailing Address - Country:US
Mailing Address - Phone:646-389-9344
Mailing Address - Fax:844-458-8359
Practice Address - Street 1:817 BROADWAY
Practice Address - Street 2:SUITE 1807
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4709
Practice Address - Country:US
Practice Address - Phone:646-389-9344
Practice Address - Fax:844-458-8359
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-25
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF401785-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health