Healthcare Provider Details

I. General information

NPI: 1972795144
Provider Name (Legal Business Name): MONIKA RUKUS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 08/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 CONNECTICUT AVE
CHEVY CHASE MD
20815-6734
US

IV. Provider business mailing address

8901 CONNECTICUT AVE
CHEVY CHASE MD
20815-6734
US

V. Phone/Fax

Practice location:
  • Phone: 301-986-9999
  • Fax:
Mailing address:
  • Phone: 301-986-9999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number08641
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberU00281
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR060195
License Number StateMD

VIII. Authorized Official

Name: MONIKA RUKUS
Title or Position: PRESIDENT
Credential: NP, LCSW-C, LAC
Phone: 301-986-9999