Provider Demographics
NPI:1659561199
Name:RUBIN, RICHARD LAZAR (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LAZAR
Last Name:RUBIN
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 1:170 W OAKRIDGE PARK
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-4021
Mailing Address - Country:US
Mailing Address - Phone:504-454-8039
Mailing Address - Fax:504-837-9874
Practice Address - Street 1:170 W OAKRIDGE PARK
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-4021
Practice Address - Country:US
Practice Address - Phone:504-454-8039
Practice Address - Fax:504-837-9874
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.012123207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology