Healthcare Provider Details

I. General information

NPI: 1508176512
Provider Name (Legal Business Name): MELISSA RUOFF RUOFF HILGERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2010
Last Update Date: 10/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 JOYS LN
KINGSTON NY
12401-3705
US

IV. Provider business mailing address

15 JOYS LN
KINGSTON NY
12401-3705
US

V. Phone/Fax

Practice location:
  • Phone: 845-331-5064
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number381852-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: