Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | N005438 | NY |
Y | 222Z00000X | Podiatrist | N005438 | NY |
NPI | 1043371685 |
---|---|
Provider Name | Andrew Rubin |
First Address | Melville, NY 11747-4230 |
Second Address | Ozone Park, NY 11416-1527 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 18/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U70768 | (02) | NY |