Healthcare Provider Details

I. General information

NPI: 1427942259
Provider Name (Legal Business Name): LEAH RUBIN PSYCHOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1019 BROADWAY STE 208
WOODMERE NY
11598-1227
US

IV. Provider business mailing address

264 FAIRLAWN AVE
WEST HEMPSTEAD NY
11552-2108
US

V. Phone/Fax

Practice location:
  • Phone: 516-986-7345
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: LEAH RUBIN
Title or Position: OWNER
Credential: PSYD
Phone: 516-986-7345