Provider Demographics
NPI:1598913402
Name:RUVINSKY, SARA C
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:C
Last Name:RUVINSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:CABASSO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, MS
Mailing Address - Street 1:40 OCEAN PKWY
Mailing Address - Street 2:#5J
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-1536
Mailing Address - Country:US
Mailing Address - Phone:718-851-2414
Mailing Address - Fax:
Practice Address - Street 1:40 OCEAN PKWY
Practice Address - Street 2:#5J
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-1536
Practice Address - Country:US
Practice Address - Phone:718-851-2414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019320-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist