Provider Demographics
NPI:1629062765
Name:RUBEN, RICHARD G (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:G
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 1:281 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-2543
Mailing Address - Country:US
Mailing Address - Phone:781-272-2210
Mailing Address - Fax:781-229-8324
Practice Address - Street 1:281 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-2543
Practice Address - Country:US
Practice Address - Phone:781-272-2210
Practice Address - Fax:781-229-8324
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59179208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
D87934Medicare UPIN