Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 081098 | NY |
NPI | 1003830860 |
---|---|
Provider Name | Edward Rubin |
First Address | Elmhurst, NY 11373-1329 |
Second Address | Elmhurst, NY 11373-1329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 23/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00116683 | (05) | NY |
C06602 | (02) | NY |