Basic Information
| Provider Information | |||||||||
| NPI: | 1629332994 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SUMBLER | ||||||||
| FirstName: | RUTH | ||||||||
| MiddleName: | BRUNILDA | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LPN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5414 BINGHAM ST | ||||||||
| Address2: | |||||||||
| City: | PHILA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191202643 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152890536 | ||||||||
| FaxNumber: | 2152890536 | ||||||||
| Practice Location | |||||||||
| Address1: | 909 SUMNEYTOWN PIKE | ||||||||
| Address2: | |||||||||
| City: | SPRING HOUSE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194771011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156431200 | ||||||||
| FaxNumber: | 2155400756 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2012 | ||||||||
| LastUpdateDate: | 07/01/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | PN052556L | PA | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.