Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | MD034864E | PA |
NPI | 1245369297 |
---|---|
Provider Name | Dr. Elyse S. Rubenstein |
First Address | Devon, PA 19333 |
Second Address | Devon, PA 19333 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2007 |
Last Update Date | 30/10/2009 |