Provider Demographics
NPI:1174858716
Name:RUBIO, DENISE (RN)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:RUBIO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-2522
Mailing Address - Country:US
Mailing Address - Phone:518-462-1094
Mailing Address - Fax:518-462-1097
Practice Address - Street 1:314 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-2522
Practice Address - Country:US
Practice Address - Phone:518-462-1094
Practice Address - Fax:518-462-1097
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY603497-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health