Provider Demographics
NPI:1144215948
Name:RUBENSTEIN, DOV (DPM)
Entity Type:Individual
Prefix:DR
First Name:DOV
Middle Name:
Last Name:RUBENSTEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:659 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-3534
Mailing Address - Country:US
Mailing Address - Phone:516-385-5794
Mailing Address - Fax:718-961-5320
Practice Address - Street 1:659 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-3534
Practice Address - Country:US
Practice Address - Phone:516-385-5794
Practice Address - Fax:718-961-5320
Is Sole Proprietor?:No
Enumeration Date:2005-09-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004793213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01267550Medicaid
NY02807Medicare ID - Type Unspecified
NYP55381Medicare ID - Type Unspecified
NY01267550Medicaid