Healthcare Provider Details

I. General information

NPI: 1144215948
Provider Name (Legal Business Name): DOV RUBENSTEIN D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

659 EUCLID AVE
WEST HEMPSTEAD NY
11552-3534
US

IV. Provider business mailing address

659 EUCLID AVE
WEST HEMPSTEAD NY
11552-3534
US

V. Phone/Fax

Practice location:
  • Phone: 516-385-5794
  • Fax: 718-961-5320
Mailing address:
  • Phone: 516-385-5794
  • Fax: 718-961-5320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN004793
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: