Healthcare Provider Details

I. General information

NPI: 1679499172
Provider Name (Legal Business Name): NEW YORK UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4074 NORTHLAKE BLVD
PALM BEACH GARDENS FL
33410-6257
US

IV. Provider business mailing address

4074 NORTHLAKE BLVD
PALM BEACH GARDENS FL
33410-6257
US

V. Phone/Fax

Practice location:
  • Phone: 561-209-6900
  • Fax:
Mailing address:
  • Phone: 561-209-6900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) 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