Provider Demographics
NPI:1790729960
Name:RUBIN, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:RUBIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 E CRESCENT AVE
Mailing Address - Street 2:C/O HISTOPATHOLOGY SERVICES, LLC
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2922
Mailing Address - Country:US
Mailing Address - Phone:201-661-7280
Mailing Address - Fax:201-661-7297
Practice Address - Street 1:255 LAFAYETTE AVE
Practice Address - Street 2:GOOD SAMARITAN HOSPITAL
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4812
Practice Address - Country:US
Practice Address - Phone:845-368-5179
Practice Address - Fax:201-661-7297
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206748207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY220033369OtherRAILROAD MEDICARE
NJ0038512Medicaid
NJ084232TGNMedicare PIN
NY220033369OtherRAILROAD MEDICARE
NYG05938Medicare UPIN