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General NPI Number Information
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NPI Number | 1801062211
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Entity Type | Individual
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Provider Name | ANTHONY THOMAS RUVOLO PHD
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Gender | Male
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Dates
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Enumeration Date | 05/06/2008
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Last Update Date | 06/20/2022
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Provider Practice Location Address
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Address Line | 1000 LAKE ST STE C8
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City | RAMSEY
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State | NJ
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Zip | 07446-1249
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Country | US
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Telephone | 201-259-4037
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Fax | 201-825-7550
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Provider Business Mailing Address
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Address Line | 19 SPEAR ROAD SUITE #312
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City | RAMSEY
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State | NJ
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Zip | 07446
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Country | US
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Telephone | 201-259-4037
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Fax | 201-825-7550
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 37PC00064800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 37PC00064800
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License Number State | NJ
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