Healthcare Provider Details

I. General information

NPI: 1700612504
Provider Name (Legal Business Name): SOLOMON RUBINSTEIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2024
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 GRAND ST
NEW YORK NY
10002-7477
US

IV. Provider business mailing address

1833 MADISON PL
BROOKLYN NY
11229-2629
US

V. Phone/Fax

Practice location:
  • Phone: 212-420-1970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberP130472
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: