Provider Demographics
NPI:1790034262
Name:BERNARD, RUTH MAXIMA (MSED)
Entity type:Individual
Prefix:MISS
First Name:RUTH
Middle Name:MAXIMA
Last Name:BERNARD
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 LINDEN BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2708
Mailing Address - Country:US
Mailing Address - Phone:347-563-5456
Mailing Address - Fax:
Practice Address - Street 1:346 LINDEN BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2708
Practice Address - Country:US
Practice Address - Phone:347-563-5456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist