Healthcare Provider Details

I. General information

NPI: 1376054577
Provider Name (Legal Business Name): RUMA MARSHALL MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RUMA RANJIT

II. Dates (important events)

Enumeration Date: 10/16/2017
Last Update Date: 10/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MULBERRY ST
SCRANTON PA
18503-1230
US

IV. Provider business mailing address

16 HULSE ST
THROOP PA
18512-1318
US

V. Phone/Fax

Practice location:
  • Phone: 570-507-9272
  • Fax:
Mailing address:
  • Phone: 570-604-0949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW125867
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: