Provider Demographics
NPI:1043258916
Name:RUBIN, JANIS W (MD)
Entity Type:Individual
Prefix:
First Name:JANIS
Middle Name:W
Last Name:RUBIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 789967
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-9967
Mailing Address - Country:US
Mailing Address - Phone:484-622-7395
Mailing Address - Fax:484-622-7399
Practice Address - Street 1:4070 BUTLER PIKE STE 200
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1510
Practice Address - Country:US
Practice Address - Phone:610-825-5741
Practice Address - Fax:610-825-2501
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD022760E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0098976OtherAETNA HMO
PA350928OtherPHCS
PA17213-MD022760EOtherHEALTH PARTNERS
PA0058561000OtherIBC - PC/KHPE
PA080091786OtherRRM
PA1021711OtherKEYSTONE MERCY
PA4657574OtherAETNA PPO
PA0082925402OtherAMERICHOICE (UHC MA PLAN)
PA417878OtherHIGHMARK BLUE SHIELD
PAP414313OtherOXFORD
PA0008292540003Medicaid
PA10935271OtherCAQH ID#
PA1270591OtherCIGNA HMO/PPO
PA223698OtherALLIANCE/OPT CHC (MAMSI)
PA0058561000OtherAMERIHEALTH/INTERCOUNTY
PA0098976OtherAETNA HMO