MEDICARE: ANIL K RUSTGI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD066015L	PA
2	207R00000X	Internal Medicine Physician	299613	NY
3	207RG0100X	Gastroenterology Physician	MD066015L	PA
4	207RG0100X	Gastroenterology Physician	299613	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609919588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANIL K RUSTGI MD

Provider Business Mailing Address
First Line	:	1130 SAINT NICHOLAS AVE RM 201
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-3802
Country	:	US
Telephone Number	:	212-851-4822
Fax Number	:	212-851-4660

Provider Business Practice Location Address
First Line	:	1130 SAINT NICHOLAS AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-3802
Country	:	US
Telephone Number	:	212-851-4822
Fax Number	:	212-851-4660

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	11/19/2024

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Directions to “ ANIL K RUSTGI MD” Practice Location

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