Provider Demographics
NPI:1821151747
Name:RUBELL, ROBIN MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:MICHELLE
Last Name:RUBELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 E 72ND ST APT 8B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4562
Mailing Address - Country:US
Mailing Address - Phone:917-209-0108
Mailing Address - Fax:
Practice Address - Street 1:345 E 37TH ST
Practice Address - Street 2:SUITE #307
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3256
Practice Address - Country:US
Practice Address - Phone:212-532-5355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY231240207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
08746WS011Medicare PIN