1861690901 NPI number — LKRUBENSTEIN PLLC

Table of content: (NPI 1861690901)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861690901 NPI number — LKRUBENSTEIN PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LKRUBENSTEIN PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1861690901
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/10/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12725 MCMANUS BLVD STE 1B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWPORT NEWS
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23602-4402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-874-0990
Provider Business Mailing Address Fax Number:
757-874-7819

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12725 MCMANUS BLVD STE 1B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWPORT NEWS
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23602-4402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-874-0990
Provider Business Practice Location Address Fax Number:
757-874-7819
Provider Enumeration Date:
07/10/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RUBENSTEIN
Authorized Official First Name:
LORETTA
Authorized Official Middle Name:
KAREN
Authorized Official Title or Position:
DOCTOR/OWNER
Authorized Official Telephone Number:
757-874-0990

Provider Taxonomy Codes

  • Taxonomy code: 1223X0400X , with the licence number:  0401005748 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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