MEDICARE: PATRICIA RUIZ DDS PC

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	261QD0000X	Dental Clinic/Center	19027	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700094232
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATRICIA RUIZ DDS PC

Provider Business Mailing Address
First Line	:	5809 MADISON ST
Second Line	:	SUITE 2
City	:	WEST NEW YORK
State	:	NJ
Zip	:	07093-1289
Country	:	US
Telephone Number	:	201-223-5533
Fax Number	:	201-223-5888

Provider Business Practice Location Address
First Line	:	5809 MADISON ST
Second Line	:	SUITE 2
City	:	WEST NEW YORK
State	:	NJ
Zip	:	07093-1289
Country	:	US
Telephone Number	:	201-223-5533
Fax Number	:	201-223-5888

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PATRICIA E DELGADO
Credential	:	DDS
Telephone Number	:	201-223-5533

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	04/08/2015

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