Healthcare Provider Details

I. General information

NPI: 1770256216
Provider Name (Legal Business Name): NEW YORK UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2021
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 QUANTUM BLVD
BOYNTON BEACH FL
33426-8668
US

IV. Provider business mailing address

893 E MAIN ST
RIVERHEAD NY
11901-2613
US

V. Phone/Fax

Practice location:
  • Phone: 877-648-2964
  • Fax:
Mailing address:
  • Phone: 631-386-3500
  • Fax: 929-455-9628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREW T. RUBIN
Title or Position: SR. VP CLINICAL AFFAIRS, AMB CARE
Credential:
Phone: 212-263-2672