Basic Information
| Provider Information | |||||||||
| NPI: | 1700033123 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RUFF | ||||||||
| FirstName: | NOREEN | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | R.P.A.-C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 220 STEUBEN ST | ||||||||
| Address2: | |||||||||
| City: | MONTOUR FALLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 148659740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6075357121 | ||||||||
| FaxNumber: | 6075354433 | ||||||||
| Practice Location | |||||||||
| Address1: | 220 STEUBEN ST | ||||||||
| Address2: | |||||||||
| City: | MONTOUR FALLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 148659740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6075357121 | ||||||||
| FaxNumber: | 6075354433 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2008 | ||||||||
| LastUpdateDate: | 06/20/2016 | ||||||||
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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 | 363A00000X | 003530-1 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | 50484A | 01 | MEDICARE | OTHER | 00722803 | 05 | NY | MEDICAID |