Basic Information
| Provider Information | |||||||||
| NPI: | 1598058851 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DIWAN | ||||||||
| FirstName: | RUFFAIDA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 529 E 235TH ST | ||||||||
| Address2: | APT 5C | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104702455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3472854020 | ||||||||
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| Practice Location | |||||||||
| Address1: | MONTEFIORE MEDICAL CENTER | ||||||||
| Address2: | 111 EAST 210TH STREET | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10467 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189042400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2011 | ||||||||
| LastUpdateDate: | 10/24/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 272141 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.