Healthcare Provider Details

I. General information

NPI: 1528740446
Provider Name (Legal Business Name): RIVKA DEUTSCH AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2023
Last Update Date: 08/20/2023
Certification Date: 08/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CADMAN PLZ W STE 1301
BROOKLYN NY
11201-3229
US

IV. Provider business mailing address

660 WHITE PLAINS ROAD - ENTA FOURTH FLOOR
TARRYTOWN NY
10591-6802
US

V. Phone/Fax

Practice location:
  • Phone: 718-208-4449
  • Fax:
Mailing address:
  • Phone: 914-984-2552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number003182
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: