Provider Demographics
NPI:1811287436
Name:RUFF, KRISTINA THERESIA (DPM)
Entity type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:THERESIA
Last Name:RUFF
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7844 METROPOLITAN AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-2966
Mailing Address - Country:US
Mailing Address - Phone:718-326-4789
Mailing Address - Fax:718-326-0828
Practice Address - Street 1:7844 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-2966
Practice Address - Country:US
Practice Address - Phone:718-326-4789
Practice Address - Fax:718-326-0828
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-16
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NYN006699213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program