Individual provider Active NPI

Ruthlynne S Nack

  • Pediatric Neurodevelopmental Disabilities Physician
  • Flushing, NY
National Provider Identifier
1346191046
Registry record updated Feb 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Neurodevelopmental Disabilities PhysicianTaxonomy code 2080P0008X
License
590705051 Issued in NY
Practice address
4705 156TH St
Flushing, NY 11355-2341
Phone
(718) 751-5770
NPI assigned
Feb 7, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X 590705051 NY Primary

Addresses

Primary practice location

4705 156TH St
Flushing, NY 11355-2341

Mailing address

4705 156TH St
Flushing, NY 11355-2341
Phone (718) 751-5770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
590705051NYMDPediatric Neurodevelopmental Disabilities Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1770422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770422400000",
    "number": "1346191046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 156TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552341",
            "telephone_number": "718-751-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 156TH ST",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552341",
            "telephone_number": "718-751-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NACK",
        "first_name": "RUTHLYNNE",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-07",
        "last_updated": "2026-02-07",
        "certification_date": "2026-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "NY",
            "license": "590705051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.