Provider Demographics
NPI:1245369297
Name:RUBENSTEIN, ELYSE S (MD)
Entity type:Individual
Prefix:DR
First Name:ELYSE
Middle Name:S
Last Name:RUBENSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 LADDERBACK LN.
Mailing Address - Street 2:
Mailing Address - City:DEVON
Mailing Address - State:PA
Mailing Address - Zip Code:19333
Mailing Address - Country:US
Mailing Address - Phone:610-254-8515
Mailing Address - Fax:610-341-0584
Practice Address - Street 1:185 LADDERBACK LN.
Practice Address - Street 2:
Practice Address - City:DEVON
Practice Address - State:PA
Practice Address - Zip Code:19333
Practice Address - Country:US
Practice Address - Phone:610-254-8515
Practice Address - Fax:610-341-0584
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD034864E103TA0400X
PAMD034864-E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)