Provider Demographics
NPI:1598058851
Name:DIWAN, RUFFAIDA (MD)
Entity Type:Individual
Prefix:DR
First Name:RUFFAIDA
Middle Name:
Last Name:DIWAN
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 1:529 E 235TH ST
Mailing Address - Street 2:APT 5C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10470-2455
Mailing Address - Country:US
Mailing Address - Phone:347-285-4020
Mailing Address - Fax:
Practice Address - Street 1:MONTEFIORE MEDICAL CENTER
Practice Address - Street 2:111 EAST 210TH STREET
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-904-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-19
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY272141207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine