Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | MD020259E | PA |
NPI | 1235164104 |
---|---|
Provider Name | Stephen C Rubin |
First Address | Philadelphia, PA 19129-1302 |
Second Address | Philadelphia, PA 19111-2434 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 12/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001405415 | (05) | PA |
A62880 | (02) | PA |