Provider Demographics
NPI:1720241367
Name:RUIZ MARTINEZ, JOSE A (RPH)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:A
Last Name:RUIZ MARTINEZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SHILLINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19607-2702
Mailing Address - Country:US
Mailing Address - Phone:609-706-0192
Mailing Address - Fax:
Practice Address - Street 1:32 2ND ST
Practice Address - Street 2:
Practice Address - City:SHILLINGTON
Practice Address - State:PA
Practice Address - Zip Code:19607-2702
Practice Address - Country:US
Practice Address - Phone:609-706-0192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02909200183500000X
FLPS48849183500000X
PARP438036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist