Provider Demographics
NPI:1659586535
Name:RUBIN, SHULAMIT (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHULAMIT
Middle Name:
Last Name:RUBIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W 90TH ST
Mailing Address - Street 2:APT 6B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1234
Mailing Address - Country:US
Mailing Address - Phone:212-595-2019
Mailing Address - Fax:
Practice Address - Street 1:326 COLLEGE RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-3002
Practice Address - Country:US
Practice Address - Phone:718-549-4888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014753103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical