Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1518974138 |
---|---|
Provider Name | Mr. Michael David Rubin |
First Address | Pleasant Valley, NY 12569-7210 |
Second Address | Montrose, NY 10548 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 08/07/2007 |