Healthcare Provider Details

I. General information

NPI: 1740459056
Provider Name (Legal Business Name): RENEE RUZZI-KERN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 WATERDAM RD
MC MURRAY PA
15317-2576
US

IV. Provider business mailing address

603 BIRCH CT
BRIDGEVILLE PA
15017-3614
US

V. Phone/Fax

Practice location:
  • Phone: 724-942-1511
  • Fax: 724-942-1513
Mailing address:
  • Phone: 412-260-7185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-007549-L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: