Individual ProviderElena M Ruiz-DiazSocial WorkerBehavioral Health & Social Service ProvidersPractice Address19 Greenridge Ave, Andrus Children'S Center, White Plains, NY 10605-1201(914) 949-7680(203) 323-1251PECOS EnrollmentBased on the most recent information from CMS, provider Elena M Ruiz-Diaz does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1780732826Provider TypeIndividualFull NameRuiz-Diaz, Elena MTitleMs.CredentialLCSWGenderFemaleSole ProprietorYesEnumeration Date1/8/2007Last Updated7/26/2007Contact InformationPractice LocationPractice Address19 Greenridge Ave, Andrus Children'S Center, White Plains, NY 10605-1201Phone(914) 949-7680Fax(203) 274-5491Mailing LocationMailing Address49 Woodridge Dr S, Stamford, CT 06902-8301Phone(203) 323-1251Fax(203) 249-5048Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseRO12257-1New YorkCode1041C0700XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense001414ConnecticutProvider IdentifiersIDDescriptionIssuerID00355940DescriptionMedicaidIssuerUnlistedNew YorkID1285628552DescriptionOtherIssuerNPI JULIA DYCKMAN ANDRUSNew York