Provider Demographics
NPI:1922259480
Name:R K MEDICAL CARE P C
Entity Type:Organization
Organization Name:R K MEDICAL CARE P C
Other - Org Name:RUVIM KRUPKIN, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUVIM
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUPKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-266-1500
Mailing Address - Street 1:2844 OCEAN PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-7900
Mailing Address - Country:US
Mailing Address - Phone:718-266-1500
Mailing Address - Fax:
Practice Address - Street 1:2844 OCEAN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7900
Practice Address - Country:US
Practice Address - Phone:718-266-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-02
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208194207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01828468Medicaid
NY5525210001OtherBLUECROSS BLUESHIELD
080221000045OtherFIDELIS CARE
NY5525210001Medicare NSC
NY01828468Medicaid