Provider Demographics
NPI:1083149421
Name:RUBIN, LYNNE S (PHD)
Entity Type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:S
Last Name:RUBIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CENTRAL PARK WEST
Mailing Address - Street 2:SUTIE 1E
Mailing Address - City:NYC
Mailing Address - State:NY
Mailing Address - Zip Code:10024
Mailing Address - Country:US
Mailing Address - Phone:212-496-7252
Mailing Address - Fax:212-724-3621
Practice Address - Street 1:300 CENTRAL PARK WEST
Practice Address - Street 2:1E
Practice Address - City:NYC
Practice Address - State:NY
Practice Address - Zip Code:10024
Practice Address - Country:US
Practice Address - Phone:212-496-7252
Practice Address - Fax:212-724-3621
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR015538102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst