Provider Demographics
NPI:1699032268
Name:RS MEDICAL OFFICE P C
Entity Type:Organization
Organization Name:RS MEDICAL OFFICE P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RUMANA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SABUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-597-9020
Mailing Address - Street 1:2152 STARLING AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-4303
Mailing Address - Country:US
Mailing Address - Phone:718-597-9020
Mailing Address - Fax:718-597-9022
Practice Address - Street 1:2152 STARLING AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-4303
Practice Address - Country:US
Practice Address - Phone:718-597-9020
Practice Address - Fax:718-597-9022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-19
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226201261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02370969Medicaid
NY131AG1Medicare PIN