Provider Demographics
NPI:1578593497
Name:RUBEN, HARVEY LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:LEE
Last Name:RUBEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 AMITY RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525
Mailing Address - Country:US
Mailing Address - Phone:203-397-0064
Mailing Address - Fax:203-397-3537
Practice Address - Street 1:270 AMITY RD
Practice Address - Street 2:SUITE 130
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525
Practice Address - Country:US
Practice Address - Phone:203-397-0064
Practice Address - Fax:203-397-3537
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT0159592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
260000456Medicare ID - Type Unspecified
D02466Medicare UPIN