Provider Demographics
NPI:1255743506
Name:RUBIN, CAROL (RDN)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:
Last Name:RUBIN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 SHERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-2734
Mailing Address - Country:US
Mailing Address - Phone:551-404-3080
Mailing Address - Fax:
Practice Address - Street 1:71 SHERWOOD RD
Practice Address - Street 2:
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670-2734
Practice Address - Country:US
Practice Address - Phone:551-404-3080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist