Healthcare Provider Details

I. General information

NPI: 1396973798
Provider Name (Legal Business Name): GISELLE RUZANY L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2009
Last Update Date: 01/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2604 CONNECTICUT AVE NW SECOND FLOOR
WASHINGTON DC
20008-1547
US

IV. Provider business mailing address

341 JAMES ST
FALLS CHURCH VA
22046-4125
US

V. Phone/Fax

Practice location:
  • Phone: 703-395-7070
  • Fax: 703-536-4693
Mailing address:
  • Phone: 703-395-7070
  • Fax: 703-852-3511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPRC13911
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: