Healthcare Provider Details

I. General information

NPI: 1861603474
Provider Name (Legal Business Name): RUTH LAURIE LAX PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 HILTON AVE SUITE 6
HEMPSTEAD NY
11550-8115
US

IV. Provider business mailing address

230 HILTON AVE SUITE 6
HEMPSTEAD NY
11550-8115
US

V. Phone/Fax

Practice location:
  • Phone: 516-481-3716
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number009793-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number009793-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: