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General NPI Number Information
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NPI Number | 1003915653
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Entity Type | Individual
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Provider Name | NYDIA RUIZ JUSINO MSW
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Gender | Female
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 11/29/2011
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Provider Practice Location Address
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Address Line | URBANIZACION SANTA MARIA SHOPPING CENTER OFICINA #234 COMMUNITY CORNERSTONE OF PUERTO RICO
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City | PONCE
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State | PR
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Zip | 00737
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Country | US
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Telephone | 787-651-0030
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Fax | 787-651-0033
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Provider Business Mailing Address
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Address Line | CALLE ALDA # 1549 URB ARIZACOON CARIBE
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City | RIO PIEDRAS
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-622-9797
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Fax | 787-622-9888
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 7618
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License Number State | PR
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