Provider Demographics
NPI:1043455124
Name:UY, RUBY ROSE (RPT)
Entity type:Individual
Prefix:MS
First Name:RUBY ROSE
Middle Name:
Last Name:UY
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 46TH RD APT 2A
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-5259
Mailing Address - Country:US
Mailing Address - Phone:718-786-4296
Mailing Address - Fax:718-786-4296
Practice Address - Street 1:1040 46TH RD. APT. 2A
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-5334
Practice Address - Country:US
Practice Address - Phone:718-786-4296
Practice Address - Fax:718-786-4296
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0241322251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics