Provider Demographics
NPI:1093808339
Name:RUBIN, TRUDY (MD)
Entity Type:Individual
Prefix:
First Name:TRUDY
Middle Name:
Last Name:RUBIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 NETHERLAND AVE
Mailing Address - Street 2:APT.705
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-4801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:39 E 78TH ST
Practice Address - Street 2:SUITE 5W
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-0213
Practice Address - Country:US
Practice Address - Phone:646-243-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1729622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry