Provider Demographics
NPI:1710520614
Name:RUBIN, TONYA (PA-C)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:RUBIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:
Other - Last Name:GAYMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:5354 HAMILTON BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18106-9775
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5354 HAMILTON BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9775
Practice Address - Country:US
Practice Address - Phone:484-221-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207N00000X
PAMA061125207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology