Provider Demographics
NPI:1679810428
Name:RUBINSON, BARRY (SLP)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:RUBINSON
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ARLYN RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-2552
Mailing Address - Country:US
Mailing Address - Phone:203-240-0813
Mailing Address - Fax:203-270-3769
Practice Address - Street 1:11 ARLYN RIDGE RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-2552
Practice Address - Country:US
Practice Address - Phone:203-240-0813
Practice Address - Fax:203-270-3769
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002796235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist