Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 09272 | CT |
Y | 213EG0000X | General Practice | 09272 | CT |
NPI | 1003934233 |
---|---|
Provider Name | Dr. Todd Barry Rubin |
First Address | West Hartford, CT 06107-1743 |
Second Address | South Windsor, CT 06074-3737 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 08/07/2007 |