Provider Demographics
NPI:1396710463
Name:RUTNER, DANIELLA (OD)
Entity type:Individual
Prefix:DR
First Name:DANIELLA
Middle Name:
Last Name:RUTNER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 WEST 42ND STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036
Mailing Address - Country:US
Mailing Address - Phone:212-938-5834
Mailing Address - Fax:212-938-4037
Practice Address - Street 1:33 WEST 42ND STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036
Practice Address - Country:US
Practice Address - Phone:212-938-5834
Practice Address - Fax:212-938-4037
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT006586152W00000X, 152WC0802X, 152WV0400X, 152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152W00000XEye and Vision Services ProvidersOptometrist
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics