1447421276 NPI number — DR. MITCHELL C RUBIN D.C.

Table of content: DR. MITCHELL C RUBIN D.C. (NPI 1447421276)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447421276 NPI number — DR. MITCHELL C RUBIN D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUBIN
Provider First Name:
MITCHELL
Provider Middle Name:
C
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RUBIN
Provider Other First Name:
MITCHELL
Provider Other Middle Name:
C
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.C.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1447421276
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/20/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8811 JAMAICA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WOODHAVEN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11421-2039
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-847-4222
Provider Business Mailing Address Fax Number:
718-847-4222

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8811 JAMAICA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WOODHAVEN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11421-2039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-847-4222
Provider Business Practice Location Address Fax Number:
718-441-4117
Provider Enumeration Date:
03/19/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  7908 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 111N00000X , with the licence number: 011570 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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