MEDICARE: RUBY REY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	25MG00060300	NJ

General Provider Information

NPI Number	:	1013208503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUBY REY

Provider Business Mailing Address
First Line	:	6313 KENNEDY BLVD
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-3420
Country	:	US
Telephone Number	:	201-861-3004
Fax Number	:

Provider Business Practice Location Address
First Line	:	6313 KENNEDY BLVD
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-3420
Country	:	US
Telephone Number	:	201-861-3004
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2011
Last Update Date	:	05/02/2011

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Directions to “ RUBY REY ” Practice Location

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