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General NPI Number Information
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NPI Number | 1841594066
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Entity Type | Organization
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Legal Business Name | ROSLYN PULMONARY AND CRITICAL CARE PC
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Dates
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Enumeration Date | 01/03/2011
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Last Update Date | 01/24/2021
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Provider Practice Location Address
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Address Line | 175 W 76TH ST APT 7A
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City | NEW YORK
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State | NY
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Zip | 10023-8307
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Country | US
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Telephone | 212-877-4850
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Fax |
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Provider Business Mailing Address
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Address Line | 175 W 76TH ST APT 7A
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City | NEW YORK
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State | NY
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Zip | 10023-8307
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Country | US
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Telephone | 646-872-4066
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | GREG RUSKIN
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Credential |
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Telephone | 212-877-4850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 135600
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License Number State | NY
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