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General NPI Number Information
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NPI Number | 1609866268
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Entity Type | Organization
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Legal Business Name | NYUMC PEDIATRIC CARDIOLOGY
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Dates
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Enumeration Date | 10/25/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 530 1ST AVE SK 9U
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City | NEW YORK
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State | NY
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Zip | 10016-6402
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Country | US
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Telephone | 212-263-5808
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Fax |
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Provider Business Mailing Address
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Address Line | 530 1ST AVE SK 9U
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City | NEW YORK
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State | NY
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Zip | 10016-6402
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Country | US
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Telephone | 212-263-5808
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Fax |
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Authorized Official
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Title or Position | SR. ASST. DEAN OF CLINICIAL AFFAIRS
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Name | ANDREW T. RUBIN
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Credential |
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Telephone | 212-263-2824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number |
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License Number State | NY
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