Provider Demographics
NPI:1386787034
Name:RUANE, ELAINE LINDA (LPN)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:LINDA
Last Name:RUANE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:ELAINE
Other - Middle Name:LINDA
Other - Last Name:RUANE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:7 PEACE CT
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-2288
Mailing Address - Country:US
Mailing Address - Phone:631-696-6971
Mailing Address - Fax:
Practice Address - Street 1:7 PEACE CT
Practice Address - Street 2:
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-2288
Practice Address - Country:US
Practice Address - Phone:631-696-6971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY130026-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY130926-1OtherLPN LICENSE #