Provider Demographics
NPI:1518977115
Name:RUBINSTEIN, KAREL ELLEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREL
Middle Name:ELLEN
Last Name:RUBINSTEIN
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 1:6 THE GRN
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06019-3172
Mailing Address - Country:US
Mailing Address - Phone:860-693-8020
Mailing Address - Fax:860-722-3089
Practice Address - Street 1:6 THE GRN
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:CT
Practice Address - Zip Code:06019-3172
Practice Address - Country:US
Practice Address - Phone:860-693-8020
Practice Address - Fax:860-722-3089
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00825103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
108527OtherVALUE OPTIONS PROVIDER#
P745096OtherOXFOR DHEATH PLANS PIN
0005973482OtherAETNA USHC PIN
CT060000825CT01OtherBCBS PROVIDER NUMBER
108527OtherVALUE OPTIONS PROVIDER#