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General NPI Number Information
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NPI Number | 1992240873
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Entity Type | Individual
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Provider Name | RUTH ALEA NP-C
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Gender | Female
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Dates
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Enumeration Date | 12/30/2016
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Last Update Date | 12/30/2016
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Provider Practice Location Address
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Address Line | 24 HILLSIDE AVE
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City | ROCKAWAY
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State | NJ
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Zip | 07866-4100
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Country | US
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Telephone | 201-874-2790
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Fax |
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Provider Business Mailing Address
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Address Line | 24 HILLSIDE AVE
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City | ROCKAWAY
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State | NJ
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Zip | 07866-4100
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Country | US
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Telephone | 201-874-2790
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 26NJ00693800
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License Number State | NJ
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