Provider Demographics
NPI:1376065763
Name:RUMA, TASLIMA A
Entity Type:Individual
Prefix:
First Name:TASLIMA
Middle Name:A
Last Name:RUMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 CROSBY AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-5201
Mailing Address - Country:US
Mailing Address - Phone:718-822-2138
Mailing Address - Fax:718-822-6515
Practice Address - Street 1:1624 CROSBY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-5201
Practice Address - Country:US
Practice Address - Phone:718-822-2138
Practice Address - Fax:718-822-6515
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-07
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF341419363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2017000325OtherANCC