DR. LISA ELLEN RUTKOVSKY (NPI# 1831129030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831129030 |
| Entity Type | Individual |
| Full Name | DR. LISA ELLEN RUTKOVSKY |
| Credential | MD |
| Practice Address |
142-23 Booth Memorial Avenue Flushing NY 11355-5343 |
| Practice Telephone | 7184609776 |
| Practice Fax Number | 3473686486 |
| Mailing Telephone | 7184609776 |
| Mailing Fax Number | 3473686486 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2013-09-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
171715 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01430340 | 05 |
| Street Address |
142-23 BOOTH MEMORIAL AVENUE |
| City | FLUSHING |
| State | NY |
| Zip Code | 11355-5343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588281364 | Antoinette Sanon | Registered Nurse | 42-49 Alban St, Flushing, NY 11355 | 2020-06-29 |
| 1336765353 | Jayesh Nakum | Physical Therapist | 43-32 Kissena Blvd, Apt # 15d, New York, NY 11355 | 2020-06-25 |
| 1417582990 | Royal Class Home Health Care Agency, Inc | Home Health | 143-26 41st Avenue 2nd Floor, Flushing, NY 11355 | 2020-03-05 |
| 1356972673 | Christine Samuel | Nurse Practitioner | Nyp Queens, 56-45 Main Street, Flushing, NY 11355 | 2020-01-27 |
| 1740842590 | Ji Nu Lee | Acupuncturist | 138 49 Barclay Ave. 6a, Flushing, NY 11355 | 2019-07-02 |
| 1386203990 | Paula Scharffenberg | Registered Nurse | 140-50 Poelar Ave, Queens, NM 11355 | 2019-06-07 |
| 1821655101 | Erin Cisney | Student in an Organized Health Care Education/Training Program | 5654 Main St, Flushing, NY 11355 | 2019-05-22 |
| 1356810063 | Sanjay Lodha Physician PC | Internal Medicine | 45 72 Parsons Lewis Blvd, Flushing, NY 11355 | 2018-11-26 |
| 1740756576 | Allday Pharmacy Inc | Pharmacy | 4199 Main St, Suite 202a, Flushing, NY 11355 | 2018-10-19 |
| 1477035806 | Xiaona Mo | Acupuncturist | 42-67 Saull St #b, Flushing, NY 11355 | 2018-09-01 |
| Find all providers in zip 11355 | ||||
| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750637328 | Ankur Bharat Shah | Pediatrics | 14601 45th Ave Ste 302, Flushing, NY 11355-2280 | 2012-07-31 |
| 1407068018 | Queens Diagnostic & Preventive Cardiac PC | Pediatrics | 157-08 45th Avenue, Flushing, NY 11355 | 2007-05-04 |
| 1659598464 | Maria Thanjan | Pediatrics | 5634 Main St, Flushing, NY 11355-5046 | 2007-04-20 |
| 1275634164 | Shiv Kuman Dube | Pediatrics | 15708 45th Ave, Flushing, NY 11355 | 2006-09-26 |
| 1184122400 | Jeffrey H. Kern Md, PC | Pediatrics | 14601 45th Ave Ste 302, Flushing, NY 11355-2280 | 2018-02-01 |
| 1881650422 | Jeffrey Kern | Pediatrics | 14601 45th Ave, Suite 408, Flushing, NY 11355-2200 | 2006-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770995771 | Susan Beker | Pediatrics | 157 Barlow Dr S, Brooklyn, NY 11234 | 2014-05-24 |
| 1750624995 | Maher Nazih Abadeer | Pediatrics | Ur Medicine Golisano Children's Hospital, 601 Elmwood Ave, Rochester, NY 14642 | 2013-04-05 |
| 1891037578 | Chalese Katche Richardson-olivier | Pediatrics | 1111 Marcus Ave Ste M15, New Hyde Park, NY 11042-1034 | 2013-03-20 |
| 1669731055 | Ian Hovis | Pediatrics | 208 E 82nd St, Apt 22, New York, NY 10028-2725 | 2012-05-07 |
| 1730447525 | Jess T. Randall | Pediatrics | 319 S. Manning Blvd, Suite 203, Albany, NY 12208 | 2012-04-30 |
| 1780975029 | Jamie K. Harrington | Pediatrics | 3959 Broadway # Chn-2, New York, NY 10032-1559 | 2011-04-20 |
| 1922397421 | Erin Paul | Pediatrics | 3959 Broadway # Chn 2-253, New York, NY 10032-1559 | 2011-04-05 |
| 1386964419 | Amee Shah | Pediatrics | 545 W 110th St, Apt 6f, New York, NY 10025-2015 | 2010-06-11 |
| 1134442999 | Ivan G Dimich | Pediatrics | 201east79thstreetsuite, 20 E, New York, NY 10075-0836 | 2010-03-09 |
| 1902059207 | Jeffrey Dayton | Pediatrics | 525 E 68th St # F-695b, Box 104, New York, NY 10065-4870 | 2008-10-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.