Provider Demographics
NPI:1306949839
Name:RUIT, PRAPHUL T (DPT)
Entity type:Individual
Prefix:MRS
First Name:PRAPHUL
Middle Name:T
Last Name:RUIT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 PLEASANT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9627
Mailing Address - Country:US
Mailing Address - Phone:717-757-3537
Mailing Address - Fax:717-718-8665
Practice Address - Street 1:2300 PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-9627
Practice Address - Country:US
Practice Address - Phone:717-757-3537
Practice Address - Fax:717-718-8665
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018173225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPT018173OtherLICENSE #
PA1017460790002Medicaid
PA118292HDXMedicare PIN
PAPT018173OtherLICENSE #