Healthcare Provider Details

I. General information

NPI: 1689384885
Provider Name (Legal Business Name): RYD AUDIOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2022
Last Update Date: 11/29/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 E 62ND ST STE 1F
NEW YORK NY
10065-8901
US

IV. Provider business mailing address

9 E 62ND ST STE 1F
NEW YORK NY
10065-8901
US

V. Phone/Fax

Practice location:
  • Phone: 212-301-7779
  • Fax: 917-688-2525
Mailing address:
  • Phone: 212-301-7779
  • Fax: 917-688-2525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: RUFINA YAKUBOV
Title or Position: PRESIDENT
Credential: AUDIOLOGIST
Phone: 718-490-7195