Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 13754 | RI |
Y | 207X00000X | Orthopaedic Surgeon | 47024 | CT |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 13754 | RI |
NPI | 1184807729 |
---|---|
Provider Name | Dr. Lee Eric Rubin |
First Address | New Haven, CT 06510-3209 |
Second Address | New Haven, CT 06519-1369 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2007 |
Last Update Date | 03/11/2016 |