Provider Demographics
NPI:1629511324
Name:FREEMAN, RUBINI S (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RUBINI
Middle Name:S
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MRS
Other - First Name:RUBY
Other - Middle Name:S
Other - Last Name:FREEMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLPP
Mailing Address - Street 1:200 NEDRA LANE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-1736
Mailing Address - Country:US
Mailing Address - Phone:718-984-1197
Mailing Address - Fax:718-984-2324
Practice Address - Street 1:200 NEDRA PL
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-1736
Practice Address - Country:US
Practice Address - Phone:718-984-1197
Practice Address - Fax:718-984-2324
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018674235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist