Provider Demographics
NPI:1508175167
Name:RUBENSTEIN, DIANA (OTR/L)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:RUBENSTEIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3052 BRIGHTON 1ST STREET
Mailing Address - Street 2:APT 3E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4660
Mailing Address - Country:US
Mailing Address - Phone:917-615-4074
Mailing Address - Fax:
Practice Address - Street 1:3052 BRIGHTON 1ST ST
Practice Address - Street 2:APT 3E
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8088
Practice Address - Country:US
Practice Address - Phone:917-615-4074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016190225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist