Provider Demographics
NPI:1164020012
Name:RR MEDICAL OFFICE PLLC
Entity Type:Organization
Organization Name:RR MEDICAL OFFICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUBINA
Authorized Official - Middle Name:
Authorized Official - Last Name:AKHTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:929-225-9363
Mailing Address - Street 1:1509 ROWLAND ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-3111
Mailing Address - Country:US
Mailing Address - Phone:929-225-9363
Mailing Address - Fax:
Practice Address - Street 1:1447 ZEREGA AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-5411
Practice Address - Country:US
Practice Address - Phone:347-621-0500
Practice Address - Fax:347-621-0505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03386216Medicaid