Provider Demographics
NPI:1275883647
Name:HARVEY L. RUBEN, MDPC
Entity Type:Organization
Organization Name:HARVEY L. RUBEN, MDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:RUBEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-397-0064
Mailing Address - Street 1:270 AMITY RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525
Mailing Address - Country:US
Mailing Address - Phone:203-397-0064
Mailing Address - Fax:203-397-3537
Practice Address - Street 1:270 AMITY RD
Practice Address - Street 2:SUITE 130
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525
Practice Address - Country:US
Practice Address - Phone:203-397-0064
Practice Address - Fax:203-397-3537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002814363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty