Healthcare Provider Details

I. General information

NPI: 1518306166
Provider Name (Legal Business Name): SAUL HERZL RUBIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 02/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 LANGHORNE NEWTOWN RD CHCA EMERGENCY MED
LANGHORNE PA
19047-1201
US

IV. Provider business mailing address

100 PENN SQUARE EAST, 9TH FL NORTH TOWER CHCA EMERGENCY MED
PHILADELPHIA PA
19141-3018
US

V. Phone/Fax

Practice location:
  • Phone: 215-710-4760
  • Fax: 215-710-5801
Mailing address:
  • Phone: 267-425-9232
  • Fax: 267-425-9299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMT203456
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD458205
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: