Healthcare Provider Details

I. General information

NPI: 1295837680
Provider Name (Legal Business Name): DR. SANFORD MICHAEL RUBINSTEIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: SANFORD MICHAEL RUBINSTEIN DDS

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 SHELDON DRIVE
KERHONKSON NY
12446-0237
US

IV. Provider business mailing address

PO BOX 237
KERHONKSON NY
12446-0237
US

V. Phone/Fax

Practice location:
  • Phone: 845-626-7370
  • Fax: 845-626-7370
Mailing address:
  • Phone: 845-626-7370
  • Fax: 845-626-7370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number023730
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: