Healthcare Provider Details

I. General information

NPI: 1225363583
Provider Name (Legal Business Name): MR. RONALD JAMES RUZINSKY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2009
Last Update Date: 10/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2075 E WEST MAPLE RD B-207
COMMERCE TOWNSHIP MI
48390-3816
US

IV. Provider business mailing address

2075 E WEST MAPLE RD B-207
COMMERCE TOWNSHIP MI
48390-3816
US

V. Phone/Fax

Practice location:
  • Phone: 248-669-9222
  • Fax: 248-669-3866
Mailing address:
  • Phone: 248-669-9222
  • Fax: 248-669-3866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: