Provider Demographics
NPI:1114053147
Name:RUBINSTEIN, SHARON A (SLP)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:A
Last Name:RUBINSTEIN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-4635
Mailing Address - Country:US
Mailing Address - Phone:631-624-5828
Mailing Address - Fax:
Practice Address - Street 1:153 CEDAR RD
Practice Address - Street 2:
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-4635
Practice Address - Country:US
Practice Address - Phone:631-624-5828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007740-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist