1518977115 NPI number — DR. KAREL ELLEN RUBINSTEIN PH.D.

Table of content: DR. KAREL ELLEN RUBINSTEIN PH.D. (NPI 1518977115)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518977115 NPI number — DR. KAREL ELLEN RUBINSTEIN PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUBINSTEIN
Provider First Name:
KAREL
Provider Middle Name:
ELLEN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518977115
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6 THE GRN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLLINSVILLE
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06019-3172
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-693-8020
Provider Business Mailing Address Fax Number:
860-722-3089

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6 THE GRN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLLINSVILLE
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06019-3172
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-693-8020
Provider Business Practice Location Address Fax Number:
860-722-3089
Provider Enumeration Date:
08/08/2006

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: 103TC0700X , with the licence number:  00825 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 108527 . This is a "VALUE OPTIONS PROVIDER#" identifier . This identifiers is of the category "OTHER".
  • Identifier: P745096 . This is a "OXFOR DHEATH PLANS PIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0005973482 . This is a "AETNA USHC PIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 060000825CT01 . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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