Healthcare Provider Details

I. General information

NPI: 1114381266
Provider Name (Legal Business Name): TUUA RUUTIAINEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2016
Last Update Date: 06/16/2021
Certification Date: 06/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 CHESTNUT ST APT 2710
PHILADELPHIA PA
19103-4324
US

IV. Provider business mailing address

2400 CHESTNUT ST APT 2710
PHILADELPHIA PA
19103-4324
US

V. Phone/Fax

Practice location:
  • Phone: 215-225-1151
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD465030
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: