Provider Demographics
NPI:1164096699
Name:RUBIN, SANDRA SUE (MS READING LITERACY)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:SUE
Last Name:RUBIN
Suffix:
Gender:F
Credentials:MS READING LITERACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 OCEAN WATCH CT
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-5742
Mailing Address - Country:US
Mailing Address - Phone:516-384-9831
Mailing Address - Fax:
Practice Address - Street 1:101 CARMAN AVE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1156
Practice Address - Country:US
Practice Address - Phone:516-228-5331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist