Basic Information
| Provider Information | |||||||||
| NPI: | 1205168671 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ACKERT PATIERNO | ||||||||
| FirstName: | RUTH | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 91 KIPP RD | ||||||||
| Address2: | |||||||||
| City: | STAATSBURG | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125805506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8458894401 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7 MANSION ST. | ||||||||
| Address2: | |||||||||
| City: | POUGHKEEPSIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454714243 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2010 | ||||||||
| LastUpdateDate: | 02/09/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 381447-1 | NY | Y | Nursing Service Providers | Registered Nurse |
ID Information
| ID | Type | State | Issuer | Description | 381447-1 | 01 | NY | RN | OTHER |