Provider Demographics
NPI:1841207487
Name:RUBIN, BONNIE R (AUD)
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:R
Last Name:RUBIN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 S RIDGE ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573
Mailing Address - Country:US
Mailing Address - Phone:914-935-3292
Mailing Address - Fax:914-935-3294
Practice Address - Street 1:118 S RIDGE ST
Practice Address - Street 2:SUITE 4
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573
Practice Address - Country:US
Practice Address - Phone:914-935-3292
Practice Address - Fax:914-935-3294
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7661231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
390058OtherCONNECTICARE
801230M053100OtherGENERAL MOTORS
3C9839OtherHEATHNET
WS1243OtherOXFORD
142348POtherHIP
3955827OtherAETNA
2547029OtherUNITED HEALTHCARE
3955827OtherAETNA