E. Victoria Rundberg-Rivera, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

213013 Issued in NY

Practice address

Suny Putnam Hall RM 103
Stony Brook, NY 11794-0001

Phone

(631) 632-8850

NPI assigned

Jun 15, 2006

Last updated

Jun 4, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212537600000",
    "number": "1205870037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900989",
            "telephone_number": "631-632-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SUNY PUTNAM HALL RM 103",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-632-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNDBERG-RIVERA",
        "first_name": "E. VICTORIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2008-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "213013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02049012",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin William Rubin, MD
• Irina Rubin
• Deirdre Anne Rubino, MA CCC-SLP
• Dina Michele Rucco, PHARMD
• Richard C Rugen, DC
• Geoffrey McMillan Russell, MD
• Jessica Holly Russell, CNM
• Christine Elizabeth Russo, CPNP-PC
• Domenick Russo
• Lauren Nicole Russo

• Psychiatry Physician in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.