Provider Demographics
NPI:1255482691
Name:RUBENSTEIN, EDITH B (MD)
Entity Type:Individual
Prefix:DR
First Name:EDITH
Middle Name:B
Last Name:RUBENSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:119 E 84TH ST
Mailing Address - Street 2:APT. #1D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0939
Mailing Address - Country:US
Mailing Address - Phone:212-628-1204
Mailing Address - Fax:212-439-6605
Practice Address - Street 1:119 E 84TH ST
Practice Address - Street 2:APT. #1D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0939
Practice Address - Country:US
Practice Address - Phone:212-628-1204
Practice Address - Fax:212-439-6605
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1392612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY80A01600Medicare ID - Type Unspecified