Healthcare Provider Details

I. General information

NPI: 1871408278
Provider Name (Legal Business Name): JEFFREY NEAL RUBIN ED.D, M.A. M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 COUNTY ROAD 116
COCHECTON NY
12726-5713
US

IV. Provider business mailing address

421 COUNTY ROAD 116
COCHECTON NY
12726-5713
US

V. Phone/Fax

Practice location:
  • Phone: 917-542-3515
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number9433
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: