Provider Demographics
NPI:1508001819
Name:RUBIN, JOANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:
Last Name:RUBIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706-2405
Mailing Address - Country:US
Mailing Address - Phone:914-310-5447
Mailing Address - Fax:
Practice Address - Street 1:120 HAMILTON AVE
Practice Address - Street 2:120 HAMILTON AVE.
Practice Address - City:HASTINGS ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10706-2405
Practice Address - Country:US
Practice Address - Phone:914-310-5447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01301901103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1508001819OtherPNI
NY01301901OtherNYS LICENSE