Provider Demographics
NPI:1790478725
Name:NEW YORK UNIVERSITY
Entity Type:Organization
Organization Name:NEW YORK UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. VP CLINICAL AFFAIRS, AMB CARE
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-263-2672
Mailing Address - Street 1:517 ROUTE 111 STE 3B
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-4338
Mailing Address - Country:US
Mailing Address - Phone:631-486-8855
Mailing Address - Fax:631-486-8852
Practice Address - Street 1:517 ROUTE 111 STE 3B
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-4338
Practice Address - Country:US
Practice Address - Phone:631-486-8855
Practice Address - Fax:631-486-8852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty