Healthcare Provider Details

I. General information

NPI: 1497911218
Provider Name (Legal Business Name): MIRIAM RUKEYSER SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2008
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 GREENWICH HILLS DR
GREENWICH CT
06831-4967
US

IV. Provider business mailing address

99 GREENWICH HILLS DR
GREENWICH CT
06831-4967
US

V. Phone/Fax

Practice location:
  • Phone: 914-589-1541
  • Fax:
Mailing address:
  • Phone: 914-589-1541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number017638
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number004082
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: