Provider Demographics
NPI:1568406460
Name:RUBEL, LANCE (MD)
Entity Type:Individual
Prefix:DR
First Name:LANCE
Middle Name:
Last Name:RUBEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1044 NORTHERN BLVD
Mailing Address - Street 2:STE 102
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-1507
Mailing Address - Country:US
Mailing Address - Phone:516-801-6959
Mailing Address - Fax:516-801-6958
Practice Address - Street 1:1044 NORTHERN BLVD
Practice Address - Street 2:STE 102
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1507
Practice Address - Country:US
Practice Address - Phone:516-801-6959
Practice Address - Fax:516-801-6958
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2016-11-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2210871207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7X0861Medicare PIN
I04539Medicare UPIN