Peter James Rubertone
Individual provider Active NPI Cardiac-Interventional Technology Radiologic Technologist · Port Ewen, NY
NPI 1447096847 · NPPES record last updated Jul 8, 2024
Key facts
- NPI
- 1447096847
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiac-Interventional Technology Radiologic Technologist 2471C1106X
- Practice address
- 45 Riverview
Port Ewen, NY 12466-5104 - Phone
- (845) 505-4141
- NPI assigned
- Jul 4, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 595962 | NY | MD | Radiography Radiologic Technologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Computed Tomography Radiologic Technologist | 2471C3401X | |||
| Radiography Radiologic Technologist | 2471C3402X | 595962 | NY | |
| Magnetic Resonance Imaging Radiologic Technologist | 2471M1202X | |||
| Cardiac-Interventional Technology Radiologic Technologist | 2471C1106X | Yes |
Addresses
Primary practice location
45 Riverview
Port Ewen, NY 12466-5104
Mailing address
45 Riverview
Port Ewen, NY 12466-5104
Phone (845) 505-4141
Other providers in Port Ewen, NY
- Port Ewen RX Inc
- Racquel Praino
- Barbara Ann Price
- Gregory Rogers
- Mary Roosa
- Cheyanne Tallas Sandy
- Dana Mary Schechter
- Lori D Schwark
- Kate Elizabeth Shellhammer
- Megan Beth Sheth
All providers in Port Ewen, NY · Cardiac-Interventional Technology Radiologic Technologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.