1386477743 NPI number — NEW YORK UNIVERSITY

Table of content: SARA CANCRO CRNP, CNM (NPI 1992779573)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386477743 NPI number — NEW YORK UNIVERSITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW YORK UNIVERSITY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386477743
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/21/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
882 3RD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11232-1904
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-293-1400
Provider Business Mailing Address Fax Number:
332-210-7550

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
882 3RD AVE UNIT 11
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11232-1902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-293-1400
Provider Business Practice Location Address Fax Number:
332-210-7550
Provider Enumeration Date:
08/21/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RUBIN
Authorized Official First Name:
ANDREW
Authorized Official Middle Name:
Authorized Official Title or Position:
SR. VP. CLINICAL AFFAIRS & AMB CARE
Authorized Official Telephone Number:
212-263-2672

Provider Taxonomy Codes

  • Taxonomy code: 207KI0005X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)