Healthcare Provider Details

I. General information

NPI: 1003221193
Provider Name (Legal Business Name): KIRSTEN A. RUHL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2014
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 COLUMBIA TPKE STE 106
FLORHAM PARK NJ
07932-1212
US

IV. Provider business mailing address

325 COLUMBIA TPKE STE 106
FLORHAM PARK NJ
07932-1212
US

V. Phone/Fax

Practice location:
  • Phone: 973-822-2000
  • Fax: 973-822-2001
Mailing address:
  • Phone: 973-822-2000
  • Fax: 973-822-2001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number017609
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00348900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: