Provider Demographics
NPI:1821602905
Name:RUBIN, ALEXANDRA D
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:D
Last Name:RUBIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 AMBERLY RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-2502
Mailing Address - Country:US
Mailing Address - Phone:516-281-4113
Mailing Address - Fax:
Practice Address - Street 1:622 3RD AVE FL 7
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6723
Practice Address - Country:US
Practice Address - Phone:121-268-3004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist