Provider Demographics
NPI:1508064817
Name:RUBENSTEIN, JASON MITCHELL
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:MITCHELL
Last Name:RUBENSTEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3636 GREYSTONE AVE
Mailing Address - Street 2:5N
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-2018
Mailing Address - Country:US
Mailing Address - Phone:347-602-7358
Mailing Address - Fax:
Practice Address - Street 1:2269 SAW MILL RIVER RD
Practice Address - Street 2:BUILDING 1A
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-3832
Practice Address - Country:US
Practice Address - Phone:914-345-5900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist