Provider Demographics
NPI:1376824755
Name:RUBIN, RACHEL F (MA SLP-CCC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:F
Last Name:RUBIN
Suffix:
Gender:F
Credentials:MA SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 STONER AVE
Mailing Address - Street 2:APT 2T
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2118
Mailing Address - Country:US
Mailing Address - Phone:631-235-7275
Mailing Address - Fax:
Practice Address - Street 1:104 MAJESTIC DR
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-4935
Practice Address - Country:US
Practice Address - Phone:631-499-5404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist