Provider Demographics
NPI:1962733782
Name:ANFANG, RUTHIE RAPAPORT (MA)
Entity type:Individual
Prefix:MS
First Name:RUTHIE
Middle Name:RAPAPORT
Last Name:ANFANG
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 UNION TPKE
Mailing Address - Street 2:103A
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1759
Mailing Address - Country:US
Mailing Address - Phone:516-354-6882
Mailing Address - Fax:
Practice Address - Street 1:1300 UNION TPKE
Practice Address - Street 2:103A
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1759
Practice Address - Country:US
Practice Address - Phone:516-354-6882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-18
Last Update Date:2010-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001164-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist