Provider Demographics
NPI:1811904352
Name:CINTRON, RUBEN (MD)
Entity type:Individual
Prefix:
First Name:RUBEN
Middle Name:
Last Name:CINTRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 BEVERLY RD STE 120
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3700
Mailing Address - Country:US
Mailing Address - Phone:703-801-6977
Mailing Address - Fax:
Practice Address - Street 1:1420 BEVERLY RD STE 120
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3700
Practice Address - Country:US
Practice Address - Phone:703-478-0440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010520782084N0400X
VA010152078174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007110391Medicaid
VA4571 0001OtherCAREFIRST DC
VA53509304OtherCF NASCO
VA4466428OtherAETNA
VA108950OtherAMERIGROUP
VA328383OtherMAMSI/ ALLIANCE
VA108950OtherAMERIGROUP