1700612827 NPI number — RHEAM EL-ROUBY METZGER MASP, LMHC

Table of content: RHEAM EL-ROUBY METZGER MASP, LMHC (NPI 1700612827)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700612827 NPI number — RHEAM EL-ROUBY METZGER MASP, LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
METZGER
Provider First Name:
RHEAM
Provider Middle Name:
EL-ROUBY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MASP, LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
EL-ROUBY
Provider Other First Name:
RHEAM
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MASP, LMHC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1700612827
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/13/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
702 HUNTINGTON DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FISHKILL
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12524-4910
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
702 HUNTINGTON DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FISHKILL
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12524-4910
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-416-4753
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/13/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  000967 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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