Provider Demographics
NPI:1588006126
Name:RUMSTEIN, SHOSHANA
Entity Type:Individual
Prefix:MS
First Name:SHOSHANA
Middle Name:
Last Name:RUMSTEIN
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 1:911 PLAINVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-5540
Mailing Address - Country:US
Mailing Address - Phone:718-327-4596
Mailing Address - Fax:
Practice Address - Street 1:911 PLAINVIEW AVE
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-5540
Practice Address - Country:US
Practice Address - Phone:718-327-4596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-24
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY865829174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist