Provider Demographics
NPI:1407960990
Name:RUBENSTEIN, STEPHEN R (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:R
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 1:56 FRANKLIN ST.
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06706-1253
Mailing Address - Country:US
Mailing Address - Phone:203-709-8873
Mailing Address - Fax:203-709-9873
Practice Address - Street 1:70 HEMINWAY PARK RD
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:CT
Practice Address - Zip Code:06795-2612
Practice Address - Country:US
Practice Address - Phone:860-945-3350
Practice Address - Fax:860-945-3251
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT15816207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0100927OtherAETNA
CT76345OtherAMERICHOICE
CT127709OtherWELLCARE
CT110170614OtherRAILROAD MEDICARE
CT1143356OtherUSA
CT756284OtherCONNECTICARE
CT010015816CT01OtherANTHEM
CT0R3234OtherHEALTHNET
CT4112895OtherAETNA
CTP4203159OtherOXFORD
CT004230075Medicaid
CTP00964312OtherRR MEDICARE
CT3V5929OtherHEALTHNET/COMMERCIAL
CT756284OtherCONNECTICARE
CT110170614OtherRAILROAD MEDICARE
CTD03078Medicare UPIN