Basic Information
Provider Information
NPI: 1952392961
EntityType: 2
ReplacementNPI:  
OrganizationName: NEW YORK UNIVERSITY
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: NYU CARDIOLOGY ASSOCIATES
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: 2122637751
FaxNumber:  
Practice Location
Address1: 530 1ST AVE
Address2:  
City: NEW YORK
State: NY
PostalCode: 100166402
CountryCode: US
TelephoneNumber: 2122637751
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/31/2005
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
207RC0000X NYY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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