Provider Demographics
NPI:1891774915
Name:RUTSTEIN, ROBERT DAVID (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DAVID
Last Name:RUTSTEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 ASYLUM AVE STE 111
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-2416
Mailing Address - Country:US
Mailing Address - Phone:860-523-8026
Mailing Address - Fax:860-523-7622
Practice Address - Street 1:999 ASYLUM AVE STE 111
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-2416
Practice Address - Country:US
Practice Address - Phone:860-523-8026
Practice Address - Fax:860-523-7622
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTP00167213ES0131X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
061280198OtherUNITED HEALTHCARE
CT062205OtherCONNECTICARE
CT030000167CT01OtherANTHEM BLUE CROSS
CT004006813Medicaid
0176260002OtherCIGNA
480007729OtherRAILROAD MEDICARE
C14746OtherGROUP ID
HAS 5385OtherORTHONET
OP0500OtherHEALTHNET
061280198002OtherALLIED HEALTH GROUP
0744660001OtherHEALTHNOW OF NY REG A
HAS 385OtherOXFORD
CT030000167CT01OtherANTHEM BLUE CROSS
061280198OtherUNITED HEALTHCARE
CT0744660002Medicare NSC
HAS 385OtherOXFORD