Healthcare Provider Details

I. General information

NPI: 1679581698
Provider Name (Legal Business Name): NEIL S DUBIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 10/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 EAST HOLLISTER STREET
CINCINNATI OH
45219-1704
US

IV. Provider business mailing address

58 EAST HOLLISTER STREET
CINCINNATI OH
45219-1704
US

V. Phone/Fax

Practice location:
  • Phone: 513-721-1737
  • Fax: 513-287-7465
Mailing address:
  • Phone: 513-721-1737
  • Fax: 513-287-7465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35044380
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number35044380
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: