Healthcare Provider Details

I. General information

NPI: 1548076573
Provider Name (Legal Business Name): NEW YORK UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16244 S MILITARY TRL STE 560
DELRAY BEACH FL
33484-6532
US

IV. Provider business mailing address

16244 S MILITARY TRL STE 560
DELRAY BEACH FL
33484-6532
US

V. Phone/Fax

Practice location:
  • Phone: 561-495-7787
  • Fax:
Mailing address:
  • Phone: 561-495-7787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREW RUBIN
Title or Position: SR VP FOR CLINICAL AFFAIRS
Credential:
Phone: 212-263-2672