Provider Demographics
NPI:1174820047
Name:RUBIN, ANDREW LAWRENCE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:LAWRENCE
Last Name:RUBIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 FLATBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-3943
Mailing Address - Country:US
Mailing Address - Phone:718-951-0484
Mailing Address - Fax:718-252-2638
Practice Address - Street 1:1706 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-3943
Practice Address - Country:US
Practice Address - Phone:718-951-0484
Practice Address - Fax:718-252-2638
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009589-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor