Provider Demographics
NPI:1588793988
Name:KEARNEY, RUTH S (MED,CCC/SLP)
Entity type:Individual
Prefix:MS
First Name:RUTH
Middle Name:S
Last Name:KEARNEY
Suffix:
Gender:F
Credentials:MED,CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2631 RAMSHORN DR
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-2430
Mailing Address - Country:US
Mailing Address - Phone:732-528-7665
Mailing Address - Fax:
Practice Address - Street 1:2631 RAMSHORN DR
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-2430
Practice Address - Country:US
Practice Address - Phone:732-528-7665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ316689Medicare Oscar/Certification
NJ080724Medicare ID - Type UnspecifiedPART B GROUP NUMBER