Basic Information
Provider Information
NPI: 1891786489
EntityType: 2
ReplacementNPI:  
OrganizationName: NEW YORK UNIVERSITY
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: NYU WOMEN'S CANCER PROGRAM
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 530 1ST AVE
Address2:  
City: NEW YORK
State: NY
PostalCode: 100166402
CountryCode: US
TelephoneNumber: 2122633095
FaxNumber:  
Practice Location
Address1: 160 E 34TH ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100164750
CountryCode: US
TelephoneNumber: 2127315345
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/02/2005
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: RUBIN
AuthorizedOfficialFirstName: ANDREW
AuthorizedOfficialMiddleName: T.
AuthorizedOfficialTitleorPosition: SR. ASST. DEAN OF CLINICAL AFFAIRS
AuthorizedOfficialTelephone: 2122632824
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: NEW YORK UNIVERSITY
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VX0201X NYY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology

No ID Information.


Home