Basic Information
Provider Information
NPI: 1891377677
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RUANE
FirstName: CLAIRE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: UNIVERSITY HOSPITAL, ROOM I-248
Address2: 150 BERGEN ST
City: NEWARK
State: NJ
PostalCode: 071032496
CountryCode: US
TelephoneNumber: 9739726056
FaxNumber: 9739723129
Practice Location
Address1: UNIVERSITY HOSPITAL, ROOM I-248
Address2: 150 BERGEN ST
City: NEWARK
State: NJ
PostalCode: 071032496
CountryCode: US
TelephoneNumber: 9739726056
FaxNumber: 9739723129
Other Information
ProviderEnumerationDate: 04/22/2021
LastUpdateDate: 04/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/29/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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