Healthcare Provider Details
I. General information
NPI: 1184744427
Provider Name (Legal Business Name): HARVEY L. RUBEN,MD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/30/2007
Last Update Date: 06/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
270 AMITY RD 130
WOODBRIDGE CT
06525-2236
US
IV. Provider business mailing address
270 AMITY RD 130
WOODBRIDGE CT
06525-2236
US
V. Phone/Fax
- Phone: 203-397-0064
- Fax: 203-397-3537
- Phone: 203-397-0064
- Fax: 203-397-3537
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | CT |
VIII. Authorized Official
Name: DR.
HARVEY
L
RUBEN
Title or Position: PRESIDENT
Credential: MD
Phone: 203-397-0064