Ruth Kurniawati, PA-C
Physician Assistant in Springfield, MA. Individual provider (NPI-1).
NPI number1669898565
StatusActive
Last updated in NPPESDec 3, 2015
Details
- NPI
- 1669898565
- Entity type
- Individual (NPI-1)
- Name
- Ruth Kurniawati
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 16, 2014
- Last updated
- Dec 3, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA4974 | MA | Yes |
Practice location
50 Wason AveSpringfield, MA 01107-1132
Phone 413-794-2222 · Fax 413-794-1666
Mailing address
3640 Main St 103Springfield, MA 01107-1139
Phone 413-785-5321 · Fax 413-731-7130
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