Healthcare Provider Details

I. General information

NPI: 1396742862
Provider Name (Legal Business Name): JANET A RUBINSTEIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 12/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4506 12TH AVE
BROOKLYN NY
11219-2001
US

IV. Provider business mailing address

4506 12TH AVE
BROOKLYN NY
11219-2001
US

V. Phone/Fax

Practice location:
  • Phone: 718-633-3131
  • Fax: 718-633-5843
Mailing address:
  • Phone: 718-633-3131
  • Fax: 718-633-5843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number138608
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: