Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 146427 | NY |
NPI | 1164410361 |
---|---|
Provider Name | Reuben Simon Ingber |
First Address | New York, NY 10016-3540 |
Second Address | New York, NY 10016-3540 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2005 |
Last Update Date | 02/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B13138 | (02) |