Provider Demographics
NPI:1831218460
Name:JEFFREY M. RUBIN, O.D., P.C.
Entity type:Organization
Organization Name:JEFFREY M. RUBIN, O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:845-623-3500
Mailing Address - Street 1:55 OLD TURNPIKE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-2461
Mailing Address - Country:US
Mailing Address - Phone:845-623-3500
Mailing Address - Fax:845-623-2223
Practice Address - Street 1:55 OLD TURNPIKE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-2461
Practice Address - Country:US
Practice Address - Phone:845-623-3500
Practice Address - Fax:845-623-2223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004168152W00000X, 152WV0400X
NY003916152WC0802X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0092013OtherGHI
NY397349OtherEMPIRE
NYP1068808OtherOXFORD
5118769OtherCIGNA
NYC31061OtherBLUE CROSS
90580OtherUNITED HEALTHCARE
NY90580OtherAETNA
5118769OtherCIGNA
C31061Medicare PIN
0698770001Medicare NSC