Healthcare Provider Details

I. General information

NPI: 1437084662
Provider Name (Legal Business Name): MEADOWS MEDICAL CARE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8745 LAKE STREET RD
LE ROY NY
14482-9344
US

IV. Provider business mailing address

20451 SENECA MEADOWS PKWY
GERMANTOWN MD
20876-7005
US

V. Phone/Fax

Practice location:
  • Phone: 855-679-2366
  • Fax:
Mailing address:
  • Phone: 301-515-7260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFF RUIZ
Title or Position: GENERAL MANAGER
Credential:
Phone: 661-312-3970