Healthcare Provider Details

I. General information

NPI: 1487751541
Provider Name (Legal Business Name): RUTH I HUGEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5070 PARKSIDE AVE SUITE #5101
PHILADELPHIA PA
19131-4747
US

IV. Provider business mailing address

153 GLENGARRY LANE
HAINESPORT NJ
08036-2259
US

V. Phone/Fax

Practice location:
  • Phone: 215-473-3318
  • Fax: 215-473-1921
Mailing address:
  • Phone: 609-518-5160
  • Fax: 215-473-1921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number51206396
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: