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General NPI Number Information
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NPI Number | 1861603474
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Entity Type | Individual
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Provider Name | RUTH LAURIE LAX PH.D.
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Gender | Female
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 230 HILTON AVE SUITE 6
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City | HEMPSTEAD
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State | NY
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Zip | 11550-8115
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Country | US
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Telephone | 516-481-3716
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Fax |
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Provider Business Mailing Address
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Address Line | 230 HILTON AVE SUITE 6
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City | HEMPSTEAD
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State | NY
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Zip | 11550-8115
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Country | US
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Telephone |
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 009793-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 009793-1
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License Number State | NY
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