MEDICARE: WENDELYN L. RUIZ FNP-C

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	363LF0000X	Family Nurse Practitioner	F-334988	NY

General Provider Information

NPI Number	:	1568681773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDELYN L. RUIZ FNP-C

Provider Business Mailing Address
First Line	:	177 MENARD DR
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14616-4335
Country	:	US
Telephone Number	:	585-748-4010
Fax Number	:

Provider Business Practice Location Address
First Line	:	774 W MAIN ST
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14611-2331
Country	:	US
Telephone Number	:	585-464-8870
Fax Number	:

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

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	07/08/2007

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