Healthcare Provider Details
I. General information
NPI: 1346272143
Provider Name (Legal Business Name): RASHID AYYUB MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/06/2006
Last Update Date: 03/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 N. VILLAGE AVENUE
ROCKVILLE CENTRE NY
11571
US
IV. Provider business mailing address
P.O. BOX 798
ROCKVILLE CENTRE NY
11570
US
V. Phone/Fax
- Phone: 516-705-1818
- Fax:
- Phone: 516-705-1353
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 136065 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 136065-1 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: