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General NPI Number Information
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NPI Number | 1487992491
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Entity Type | Individual
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Provider Name | RUTH BLANC OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/25/2013
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Last Update Date | 01/25/2013
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Provider Practice Location Address
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Address Line | 1633 E 8TH ST
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City | BROOKLYN
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State | NY
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Zip | 11223-2217
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Country | US
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Telephone | 718-336-0265
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Fax |
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Provider Business Mailing Address
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Address Line | 1160 E 84TH ST
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City | BROOKLYN
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State | NY
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Zip | 11236-4733
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Country | US
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Telephone | 718-813-1776
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 017801
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License Number State | NY
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