Healthcare Provider Details

I. General information

NPI: 1528265154
Provider Name (Legal Business Name): RUKMANIE CUMMINGS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

592 ROCKAWAY AVE
BROOKLYN NY
11212-5539
US

IV. Provider business mailing address

1625 ROCKAWAY PKWY 6X
BROOKLYN NY
11236-4356
US

V. Phone/Fax

Practice location:
  • Phone: 718-345-5000
  • Fax:
Mailing address:
  • Phone: 718-531-2154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number492381
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: