Basic Information
| Provider Information | |||||||||
| NPI: | 1063986255 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JENNIFER M. RUH, MD, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3725 N BUFFALO RD. | ||||||||
| Address2: | |||||||||
| City: | ORCHARD PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 141271853 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7165084040 | ||||||||
| FaxNumber: | 7165088038 | ||||||||
| Practice Location | |||||||||
| Address1: | 3725 N BUFFALO RD. | ||||||||
| Address2: | |||||||||
| City: | ORCHARD PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 141271853 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7165084040 | ||||||||
| FaxNumber: | 7165088038 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2019 | ||||||||
| LastUpdateDate: | 01/28/2019 | ||||||||
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| AuthorizedOfficialLastName: | RUH | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7165084040 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.