1841207487 NPI number — MS. BONNIE R RUBIN AUD

Table of content: MS. BONNIE R RUBIN AUD (NPI 1841207487)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841207487 NPI number — MS. BONNIE R RUBIN AUD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUBIN
Provider First Name:
BONNIE
Provider Middle Name:
R
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
AUD
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:
1841207487
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:
118 S RIDGE ST
Provider Second Line Business Mailing Address:
SUITE 4
Provider Business Mailing Address City Name:
RYE BROOK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10573
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-935-3292
Provider Business Mailing Address Fax Number:
914-935-3294

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
118 S RIDGE ST
Provider Second Line Business Practice Location Address:
SUITE 4
Provider Business Practice Location Address City Name:
RYE BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10573
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-935-3292
Provider Business Practice Location Address Fax Number:
914-935-3294
Provider Enumeration Date:
08/02/2006

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: 231H00000X , with the licence number:  7661 , 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)

  • Identifier: 390058 . This is a "CONNECTICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 801230M053100 . This is a "GENERAL MOTORS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3C9839 . This is a "HEATHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: WS1243 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 142348P . This is a "HIP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3955827 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2547029 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".




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