Provider Demographics
NPI:1821088675
Name:RUBENS, JAMI R (MD)
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:R
Last Name:RUBENS
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 417400
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-0001
Mailing Address - Country:US
Mailing Address - Phone:800-360-4391
Mailing Address - Fax:770-776-5702
Practice Address - Street 1:2014 WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462
Practice Address - Country:US
Practice Address - Phone:617-243-6162
Practice Address - Fax:207-347-7401
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA530512085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3024237Medicaid
MA3024237Medicaid
1387162Medicare UPIN