Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | C50466 | MS |
NPI | 1285247783 |
---|---|
Provider Name | Jay Michael Rubenstein |
First Address | Ocean Springs, MS 39564-4370 |
Second Address | Ocean Springs, MS 39564-4370 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2020 |
Last Update Date | 25/08/2020 |