RUTH LOUISE VAN DER HEIDE

SYRACUSE, NY
NPI1013614205
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NY  033052)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2023-02-08
Last Update Date2024-11-21
Business Address
RUTH LOUISE VAN DER HEIDE
739 IRVING AVE STE 600
SYRACUSE, NY 13210-1663
Phone number: 315-701-2550
Mailing Address
RUTH LOUISE VAN DER HEIDE
214 COUNTY ROUTE 5
PULASKI, NY 13142-2214
Phone number: