Most Relevant Information
Provider Data
| NPI Number: | 1003519836 |
| Provider Name: | RUTH S DEROSENA |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 812712-01 |
Most Important Dates
| Enumeration Date: | 03/22/2023 |
| Last Updated: | 03/22/2023 |
Provider Practice Location
2811 QUEENS PLZ N FL 5
LONG ISLAND CITY
NY
111014172
Practice Location Phone/Fax
| Phone: | 7183918300 |
| Fax: |
Provider Mailing Location
2811 QUEENS PLZ N FL 5
LONG ISLAND CITY
NY
111014172
Provider Mailing Phone/Fax
| Phone: | 7183918300 |
| Fax: |