Provider Demographics
NPI:1245339308
Name:RUBINSTEIN, IAN L (MPT, MR)
Entity type:Individual
Prefix:
First Name:IAN
Middle Name:L
Last Name:RUBINSTEIN
Suffix:
Gender:M
Credentials:MPT, MR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 KING ARTHURS WAY
Mailing Address - Street 2:
Mailing Address - City:BOURNE
Mailing Address - State:MA
Mailing Address - Zip Code:02532-2376
Mailing Address - Country:US
Mailing Address - Phone:508-246-4233
Mailing Address - Fax:
Practice Address - Street 1:320 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1700
Practice Address - Country:US
Practice Address - Phone:508-246-4233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2018-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9431225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3965358OtherAETNA
MA494389OtherTUFTS
MAY67244OtherBC
MAY67244OtherBC