Provider Demographics
NPI:1689854192
Name:IAN M. RUBINS, MD, PC
Entity Type:Organization
Organization Name:IAN M. RUBINS, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:H
Authorized Official - Last Name:DONIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-618-0687
Mailing Address - Street 1:4 DEARFIELD DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-5351
Mailing Address - Country:US
Mailing Address - Phone:203-618-0687
Mailing Address - Fax:203-869-0019
Practice Address - Street 1:4 DEARFIELD DR
Practice Address - Street 2:SUITE 106
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-5351
Practice Address - Country:US
Practice Address - Phone:203-618-0687
Practice Address - Fax:203-869-0019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT033766174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT05676572OtherAETNA
CT1336207968OtherINDIVIDUAL PROVIDER NPI
CTP967462OtherOXFORD
CT010033766CT03OtherANTHEM BCBS
CTCU1896OtherACS HEALTHNET
CTP967462OtherOXFORD