Provider Demographics
NPI:1932324761
Name:RUBENSTEIN, MARC ANTON (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:ANTON
Last Name:RUBENSTEIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:34 PARK ST
Mailing Address - Street 2:CONNECTICUT MENTAL HEALTH CENTER OFFICE OF CARE MANAGEM
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519
Mailing Address - Country:US
Mailing Address - Phone:203-974-7417
Mailing Address - Fax:203-974-7413
Practice Address - Street 1:400 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-2181
Practice Address - Country:US
Practice Address - Phone:203-777-1285
Practice Address - Fax:203-974-7413
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2011-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT119612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
260002693Medicare ID - Type Unspecified
C65003Medicare UPIN