Provider Demographics
NPI:1427471689
Name:MORGESE, RUTH A (PT)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:A
Last Name:MORGESE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 DOS LOCOS
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-5014
Mailing Address - Country:US
Mailing Address - Phone:505-559-0164
Mailing Address - Fax:505-916-0727
Practice Address - Street 1:13 DOS LOCOS
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-5014
Practice Address - Country:US
Practice Address - Phone:505-559-0164
Practice Address - Fax:505-916-0727
Is Sole Proprietor?:No
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM531174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist