Provider Demographics
NPI:1528446879
Name:ENGEL, RUTH
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:ENGEL
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 1:11635 BAUGHMAN RD
Mailing Address - Street 2:
Mailing Address - City:PRATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:14873-9647
Mailing Address - Country:US
Mailing Address - Phone:607-522-5538
Mailing Address - Fax:
Practice Address - Street 1:1550 ROUTE 488
Practice Address - Street 2:MIDLAKES MIDDLE SCHOOL
Practice Address - City:CLIFTON SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:14432-9308
Practice Address - Country:US
Practice Address - Phone:315-548-6020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY286285 - 1163W00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program