Healthcare Provider Details

I. General information

NPI: 1568248276
Provider Name (Legal Business Name): ELKY RUBIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2023
Last Update Date: 08/17/2025
Certification Date: 08/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 N MAIN ST
SPRING VALLEY NY
10977-4020
US

IV. Provider business mailing address

8 MONSEY BLVD UNIT 201
MONSEY NY
10952-3463
US

V. Phone/Fax

Practice location:
  • Phone: 845-286-2210
  • Fax:
Mailing address:
  • Phone: 718-782-2225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: