Provider Demographics
NPI:1649248915
Name:ABRAMOVITZ, RUTH (MD)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:ABRAMOVITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4699
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47903-4699
Mailing Address - Country:US
Mailing Address - Phone:765-449-2732
Mailing Address - Fax:765-449-1196
Practice Address - Street 1:500 W NAVAJO ST
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47906-1999
Practice Address - Country:US
Practice Address - Phone:765-742-6774
Practice Address - Fax:765-742-6914
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01046626A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200145850Medicaid
IN815150HMedicare PIN
ING61362Medicare UPIN
INP00059471Medicare PIN