Provider Demographics
NPI:1255300877
Name:RUBINS, JONATHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:RUBINS
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:211 WHITE SPRUCE BLVD
Mailing Address - Street 2:INTERLAKES ONCOLOGY & HEMATOLOGY PC
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623
Mailing Address - Country:US
Mailing Address - Phone:585-475-8728
Mailing Address - Fax:585-475-9411
Practice Address - Street 1:675 W WASHINGTON ST
Practice Address - Street 2:INTERLAKES ONCOLOGY & HEMATOLOGY PC
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456
Practice Address - Country:US
Practice Address - Phone:315-781-2250
Practice Address - Fax:315-781-0733
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2008-04-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY116073-1207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00464526Medicaid
NY00464526Medicaid
NYB72185Medicare UPIN
NY12049FMedicare PIN