Healthcare Provider Details

I. General information

NPI: 1235711201
Provider Name (Legal Business Name): YAHAIRA GABRIELA RUIZ-RAMIREZ LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2021
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3708 91ST ST
JACKSON HEIGHTS NY
11372-7961
US

IV. Provider business mailing address

859 HOLLYWOOD AVE # 2F
BRONX NY
10465-2305
US

V. Phone/Fax

Practice location:
  • Phone: 718-706-1663
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number126353-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: