Provider Demographics
NPI:1508627365
Name:RUVINOVA, LUBOV
Entity Type:Individual
Prefix:
First Name:LUBOV
Middle Name:
Last Name:RUVINOVA
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 1:101 AVENUE U FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-3640
Mailing Address - Country:US
Mailing Address - Phone:917-696-1733
Mailing Address - Fax:718-301-1266
Practice Address - Street 1:101 AVENUE U FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-3640
Practice Address - Country:US
Practice Address - Phone:917-696-1733
Practice Address - Fax:718-301-1266
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No251B00000XAgenciesCase Management