Provider Demographics
NPI:1043583073
Name:INTENSIVE PSYCHIATRIC SERVICES PC
Entity Type:Organization
Organization Name:INTENSIVE PSYCHIATRIC SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-897-0277
Mailing Address - Street 1:PO BOX 255
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11509-0255
Mailing Address - Country:US
Mailing Address - Phone:516-897-0277
Mailing Address - Fax:516-431-8209
Practice Address - Street 1:2500 MARCUS AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1097
Practice Address - Country:US
Practice Address - Phone:516-897-0277
Practice Address - Fax:516-431-8209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1510932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty