Kelleher, Ruth Ellen

Kelleher, Ruth Ellen is an individual health care provider with primary practice located at 1 Tallow Wood Dr , Clifton Park NY 12065. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Kelleher, Ruth Ellen can be contacted via phone (518) 688-0434.

Contact Information

Primary practice address
1 Tallow Wood Dr Clifton Park NY 12065
Phone: (518) 688-0434
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 380828 New York
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 380828 New York

Profile Details

NPI number 1912126806
LBN Legal business name Kelleher, Ruth Ellen
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2007
Last updated May 11th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912126806 NPPES
New York MEDICAID 01879189

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