Provider Demographics
NPI:1326072224
Name:RUBENSTEIN, MORTON JEROME (MD)
Entity Type:Individual
Prefix:DR
First Name:MORTON
Middle Name:JEROME
Last Name:RUBENSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 BROADWELL LN
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-9238
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:97 BROADWELL LN
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-9238
Practice Address - Country:US
Practice Address - Phone:717-624-5260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD13822E207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA021526OtherHIGHMARK BLUE SHIELD
PA000777111Medicaid
PA38578OtherGEISINGER
PA037982OtherJOHNS HOPKINS
PA5125102OtherAETNA
PA110191613Medicare PIN
PA000777111Medicaid
PA021526OtherHIGHMARK BLUE SHIELD