Provider Demographics
NPI:1760537708
Name:RUBINO, DONNA MARIE (MA CCC)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIE
Last Name:RUBINO
Suffix:
Gender:F
Credentials:MA CCC
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:MARIE
Other - Last Name:RUSSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:120 MERLE AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-2235
Mailing Address - Country:US
Mailing Address - Phone:516-678-3906
Mailing Address - Fax:
Practice Address - Street 1:134 MINEOLA BLVD
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3959
Practice Address - Country:US
Practice Address - Phone:516-294-9363
Practice Address - Fax:516-294-6228
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1770237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter