Individual provider Active NPI

Marilina Rufino

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1710132006
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
021088 Issued in NY
Practice address
611 Broadway RM 718
New York, NY 10012-2649
Phone
(917) 392-8547
NPI assigned
Dec 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
Clinical Psychologist 103TC0700X 021088 NY Primary

Addresses

Primary practice location

611 Broadway RM 718
New York, NY 10012-2649

Mailing address

611 Broadway RM 718
New York, NY 10012-2649
Phone (917) 392-8547

Other practice location 1

227 Madison St
Gouverneur Healthcare Services
New York, NY 10002-7537
Phone (212) 238-7334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
021088NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1710132006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 BROADWAY RM 718",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122649",
            "telephone_number": "917-392-8547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 BROADWAY RM 718",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122649",
            "telephone_number": "917-392-8547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "227 Madison St",
            "address_2": "Gouverneur Healthcare Services",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100027537",
            "country_code": "US",
            "telephone_number": "212-238-7334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUFINO",
        "first_name": "MARILINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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.