Provider Demographics
NPI:1093785305
Name:AMARU, REBECCA C (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:C
Last Name:AMARU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1243
Mailing Address - Country:US
Mailing Address - Phone:917-492-9200
Mailing Address - Fax:917-492-8129
Practice Address - Street 1:1125 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1243
Practice Address - Country:US
Practice Address - Phone:917-492-9200
Practice Address - Fax:917-492-8129
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY217924-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02397111Medicaid
NY2342963OtherMSNYU HEALTH TOP TIER,UHC
NY3229990OtherAETNA, PPO,POS,EPO,INDEMN
NY7619499OtherAETNA, HMO
NY2342963OtherMSNYU HEALTH TOP TIER,UHC
NYI06667Medicare UPIN