Provider Demographics
NPI:1306075593
Name:RUST, MARIA N (CPNP)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:N
Last Name:RUST
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:27 W 16TH ST
Mailing Address - Street 2:APT PENTHOUSE A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6306
Mailing Address - Country:US
Mailing Address - Phone:315-415-9070
Mailing Address - Fax:
Practice Address - Street 1:525 E 68TH ST
Practice Address - Street 2:BOX 99
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-4870
Practice Address - Country:US
Practice Address - Phone:212-746-2886
Practice Address - Fax:212-746-7729
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20081987363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics