Provider Demographics
NPI:1700107281
Name:NEW YORK UNIVERSITY
Entity Type:Organization
Organization Name:NEW YORK UNIVERSITY
Other - Org Name:NYU GREAT NECK MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR ASS DEAN FOR CLINICAL AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:T
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-263-2824
Mailing Address - Street 1:488 GREAT NECK RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-4315
Mailing Address - Country:US
Mailing Address - Phone:516-482-6747
Mailing Address - Fax:516-482-4851
Practice Address - Street 1:488 GREAT NECK RD
Practice Address - Street 2:SUITE 300
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-4315
Practice Address - Country:US
Practice Address - Phone:516-482-6747
Practice Address - Fax:516-482-4851
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW YORK UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty