Provider Demographics
NPI:1932271848
Name:RUBINSTEIN, MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:RUBINSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MARK
Other - Middle Name:
Other - Last Name:RUBINSTEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:196 DANBURY RD
Mailing Address - Street 2:P.O. BOX 7204
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-4029
Mailing Address - Country:US
Mailing Address - Phone:203-762-1255
Mailing Address - Fax:203-762-1255
Practice Address - Street 1:196 DANBURY RD
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-7204
Practice Address - Country:US
Practice Address - Phone:203-762-1255
Practice Address - Fax:203-762-1255
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT025299101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional