Provider Demographics
NPI:1780745570
Name:RUBIN, MEREDITH SARAH (MA, CCC-SLP, HPCS)
Entity type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:SARAH
Last Name:RUBIN
Suffix:
Gender:F
Credentials:MA, CCC-SLP, HPCS
Other - Prefix:MS
Other - First Name:MEREDITH
Other - Middle Name:SARAH
Other - Last Name:BAZAAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CCC-SLP, HPCS
Mailing Address - Street 1:200 PINEHURST AVE APT 5G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-1741
Mailing Address - Country:US
Mailing Address - Phone:201-306-9818
Mailing Address - Fax:
Practice Address - Street 1:200 PINEHURST AVE APT 5G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-1741
Practice Address - Country:US
Practice Address - Phone:201-306-9818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00374600235Z00000X
NY010563-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist