MEDICARE: MARK I RUBIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	135924	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891777694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK I RUBIN MD

Provider Business Mailing Address
First Line	:	1250 WATERS PL
Second Line	:	1201
City	:	BRONX
State	:	NY
Zip	:	10461-2720
Country	:	US
Telephone Number	:	718-239-0115
Fax Number	:	718-239-0446

Provider Business Practice Location Address
First Line	:	1250 WATERS PL
Second Line	:	1201
City	:	BRONX
State	:	NY
Zip	:	10461-2720
Country	:	US
Telephone Number	:	718-239-0115
Fax Number	:	718-239-0446

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	05/22/2014

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Directions to “ MARK I RUBIN MD” Practice Location

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