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NPI Code Detail

MEDICARE: KIMBERLEY RUTSKY M.A., CCC-SLP

MEDICARE: KIMBERLEY RUTSKY M.A., CCC-SLP
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
1235Z00000XSpeech-Language Pathologist015725NC

General Provider Information

NPI Number : 1689714438
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLEY RUTSKY M.A., CCC-SLP
Provider Business Mailing Address
First Line : 85 JOHN ST APT 5D
Second Line :
City : NEW YORK
State : NY
Zip : 10038-2843
Country : US
Telephone Number : 212-217-1554
Fax Number :
Provider Business Practice Location Address
First Line : 2324 FOREST AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10303-1506
Country : US
Telephone Number : 718-447-0200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2007
Last Update Date : 07/08/2007

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Directions to “ KIMBERLEY RUTSKY M.A., CCC-SLP” Practice Location

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