Provider Demographics
NPI:1972557718
Name:RUBIN, ROCHELLE NINA (GNP)
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:NINA
Last Name:RUBIN
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 MONTGOMERY ST
Mailing Address - Street 2:C16
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-5659
Mailing Address - Country:US
Mailing Address - Phone:718-467-4541
Mailing Address - Fax:
Practice Address - Street 1:800 POLY PL
Practice Address - Street 2:NURSING 118
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7104
Practice Address - Country:US
Practice Address - Phone:718-836-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY340571363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology