Healthcare Provider Details

I. General information

NPI: 1407701436
Provider Name (Legal Business Name): AW MEDICAL GROUP P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 CROSBY ST FL 4
NEW YORK NY
10012-2754
US

IV. Provider business mailing address

166 CROSBY ST FL 4
NEW YORK NY
10012-2754
US

V. Phone/Fax

Practice location:
  • Phone: 302-219-4988
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: NATHAN RUCH
Title or Position: PRESIDENT
Credential: MD
Phone: 302-219-4988