Provider Demographics
NPI:1316041460
Name:RUBEN, SUSAN S (MSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:S
Last Name:RUBEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 E 61ST ST
Mailing Address - Street 2:APT 5E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8148
Mailing Address - Country:US
Mailing Address - Phone:203-918-7447
Mailing Address - Fax:
Practice Address - Street 1:167 E 61ST ST
Practice Address - Street 2:APT 5E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8148
Practice Address - Country:US
Practice Address - Phone:203-918-7447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0181781041C0700X
CT0037161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical