Organization Active NPI

New York University

Doing business as NYU Great Neck Medical

  • Internal Medicine Physician
  • Great Neck, NY
National Provider Identifier
1700107281
Registry record updated Jun 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NEW YORK UNIVERSITY
Doing business as
NYU Great Neck Medical
Practice address
488 Great Neck Rd
Suite 300
Great Neck, NY 11021-4315
Phone
(516) 482-6747
Fax
(516) 482-4851
NPI assigned
Jun 18, 2010
Organization subpart
Yes
Parent organization
NEW YORK UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 18, 2010

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

Authorized official

Name
Andrew T Rubin
Title
Sr Ass Dean for Clinical Affairs
Phone
(212) 263-2824

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X

Addresses

Primary practice location

488 Great Neck Rd
Suite 300
Great Neck, NY 11021-4315

Mailing address

488 Great Neck Rd
Suite 300
Great Neck, NY 11021-4315
Phone (516) 482-6747

Other names 1

  • NYU Great Neck Medical Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0689178NYU Great Neck Medical488 Great Neck Road, Great Neck, NY 11021Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory
Part of
NYU Anesthesia Assoc

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276819200000",
    "number": "1700107281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "488 GREAT NECK RD",
            "address_2": "SUITE 300",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214315",
            "telephone_number": "516-482-6747",
            "fax_number": "516-482-4851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "488 GREAT NECK RD",
            "address_2": "SUITE 300",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214315",
            "telephone_number": "516-482-6747",
            "fax_number": "516-482-4851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEW YORK UNIVERSITY",
        "enumeration_date": "2010-06-18",
        "last_updated": "2010-06-18",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SR ASS DEAN FOR CLINICAL AFFAIRS",
        "authorized_official_telephone_number": "212-263-2824"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NYU Great Neck Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.