Provider Demographics
NPI:1265952931
Name:RUBIO, KRISTINA
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:
Last Name:RUBIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 SICOMAC AVE
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-2159
Mailing Address - Country:US
Mailing Address - Phone:201-848-5338
Mailing Address - Fax:
Practice Address - Street 1:50 E 168TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-7929
Practice Address - Country:US
Practice Address - Phone:718-293-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-23
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL0505986700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker