Most Relevant Information
Provider Data
| NPI Number: | 1003675935 |
| Provider Name: | RUTH TYAN NP |
| Entity Type: | Individual |
| Taxonomy Code: | 163WC0200X |
| Specialty: | Registered Nurse |
| License Number: | 819042 |
Most Important Dates
| Enumeration Date: | 03/14/2024 |
| Last Updated: | 04/18/2024 |
Provider Practice Location
55 PALMER AVE
BRONXVILLE
NY
107083403
Practice Location Phone/Fax
| Phone: | 9147871000 |
| Fax: |
Provider Mailing Location
4828 TONNELLE AVE APT 1216
NORTH BERGEN
NJ
070472987
Provider Mailing Phone/Fax
| Phone: | 9735250986 |
| Fax: |