Provider Demographics
NPI:1851381750
Name:RUBIN, RICHARD B (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:B
Last Name:RUBIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2545 HEMPSTEAD TPKE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-2194
Mailing Address - Country:US
Mailing Address - Phone:516-731-0700
Mailing Address - Fax:516-731-6662
Practice Address - Street 1:2545 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE 310
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-2194
Practice Address - Country:US
Practice Address - Phone:516-731-0700
Practice Address - Fax:516-731-6662
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY202947207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEM091Medicare ID - Type Unspecified
NYG25917Medicare UPIN