Healthcare Provider Details

I. General information

NPI: 1275834830
Provider Name (Legal Business Name): MICHAEL A. RUZEK D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2010
Last Update Date: 07/17/2020
Certification Date: 07/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 TRENTON RD
BROWNS MILLS NJ
08015-1705
US

IV. Provider business mailing address

803 RAHWAY AVE
WESTFIELD NJ
07090-3435
US

V. Phone/Fax

Practice location:
  • Phone: 609-735-5962
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOT013602
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberP13-00474
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: