Provider Demographics
NPI:1457453862
Name:RUBINSTEIN, MITCHELL SCOTT (DO)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:SCOTT
Last Name:RUBINSTEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:107-40 QUEENS BLVD
Mailing Address - Street 2:SUITE #206
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375
Mailing Address - Country:US
Mailing Address - Phone:718-275-0103
Mailing Address - Fax:718-275-0104
Practice Address - Street 1:107-40 QUEENS BLVD
Practice Address - Street 2:SUITE #206
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:718-275-0103
Practice Address - Fax:718-275-0104
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2010892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
04137Medicare ID - Type Unspecified
G86334Medicare UPIN