Healthcare Provider Details

I. General information

NPI: 1831838440
Provider Name (Legal Business Name): NEW YORK UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2022
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 QUANTUM BLVD
BOYNTON BEACH FL
33426-8668
US

IV. Provider business mailing address

120 MINEOLA BLVD STE 210
MINEOLA NY
11501-4077
US

V. Phone/Fax

Practice location:
  • Phone: 877-648-2964
  • Fax:
Mailing address:
  • Phone: 516-663-4600
  • Fax: 516-663-3008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery 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