Healthcare Provider Details

I. General information

NPI: 1841381365
Provider Name (Legal Business Name): HARVEY RUBIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 02/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

779 MARIGOLD CT
BRIDGEVILLE PA
15017-3807
US

IV. Provider business mailing address

779 MARIGOLD CT
BRIDGEVILLE PA
15017-3807
US

V. Phone/Fax

Practice location:
  • Phone: 412-275-3288
  • Fax:
Mailing address:
  • Phone: 412-275-3288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberMD009743E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD009743E
License Number StatePW

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: