Provider Demographics
NPI:1972660918
Name:RUBINOFF, LAURA (MS,)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:RUBINOFF
Suffix:
Gender:F
Credentials:MS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6505 DEMOCRACY BLVD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1688
Mailing Address - Country:US
Mailing Address - Phone:301-493-4695
Mailing Address - Fax:301-299-0164
Practice Address - Street 1:6505 DEMOCRACY BLVD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1688
Practice Address - Country:US
Practice Address - Phone:301-493-4695
Practice Address - Fax:301-299-0164
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01518235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDYA67LMOtherBLUECROSSBLUESHIELD OF MD