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General NPI Number Information
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NPI Number | 1104396274
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTH NP IMMEDIATE CARE, PLLC
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Dates
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Enumeration Date | 11/30/2018
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 6280 FURNACE ROAD
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City | ONTARIO
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State | NY
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Zip | 14519
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Country | US
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Telephone | 315-791-0050
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Fax |
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Provider Business Mailing Address
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Address Line | 6280 FURNACE ROAD
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City | ONTARIO
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State | NY
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Zip | 14519
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Country | US
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Telephone | 315-791-0050
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DENISE H. RUIZ
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Credential | F.N.P.
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Telephone | 585-831-9428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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