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General NPI Number Information
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NPI Number | 1770578221
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Entity Type | Individual
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Provider Name | TIFFANY K RUTH MD
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Gender | Female
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 525 ROUTE 73 N STE 117
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City | MARLTON
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State | NJ
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Zip | 08053-3422
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Country | US
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Telephone | 800-991-6117
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Fax | 888-812-8191
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Provider Business Mailing Address
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Address Line | 3820 NORTHDALE BLVD STE 201
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City | TAMPA
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State | FL
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Zip | 33624-1893
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Country | US
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Telephone | 800-991-6117
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Fax | 888-812-8191
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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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 25MA06942900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 25MA06942900
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 25MA06942900
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License Number State | NJ
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