MEDICARE: DULCE M RUIZ AST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	25MG00161200	NJ
2	2355A2700X	Audiology Assistant	AST	NJ

General Provider Information

NPI Number	:	1487354296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DULCE M RUIZ AST

Provider Business Mailing Address
First Line	:	7401 BERGENLINE AVE
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-5438
Country	:	US
Telephone Number	:	201-854-1800
Fax Number	:	201-861-0269

Provider Business Practice Location Address
First Line	:	7401 BERGENLINE AVE
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-5438
Country	:	US
Telephone Number	:	201-854-1800
Fax Number	:	201-861-0269

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2023
Last Update Date	:	03/04/2026

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