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General NPI Number Information
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NPI Number | 1053975615
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Entity Type | Individual
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Provider Name | NICOLE B RUIZ LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/29/2019
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Last Update Date | 12/27/2023
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Provider Practice Location Address
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Address Line | 924 4TH AVE APT 2F
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City | BROOKLYN
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State | NY
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Zip | 11232-2339
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Country | US
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Telephone | 646-331-4737
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Fax |
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Provider Business Mailing Address
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Address Line | 924 4TH AVE APT 2F
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City | BROOKLYN
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State | NY
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Zip | 11232-2339
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Country | US
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Telephone | 646-331-4737
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Fax |
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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 | 105778
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License Number State | NY
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