Healthcare Provider Details

I. General information

NPI: 1750540142
Provider Name (Legal Business Name): RONNIE GUREVICH FINE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RONNIE DINA GUREVICH M.D.

II. Dates (important events)

Enumeration Date: 06/02/2008
Last Update Date: 12/18/2023
Certification Date: 12/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 E 68TH ST APT 9E
NEW YORK NY
10065-6330
US

IV. Provider business mailing address

445 E 68TH ST APT 9E
NEW YORK NY
10065-6330
US

V. Phone/Fax

Practice location:
  • Phone: 917-538-5971
  • Fax:
Mailing address:
  • Phone: 917-538-5971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number247400
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License Number247400
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: