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General NPI Number Information
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NPI Number | 1255300877
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Entity Type | Individual
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Provider Name | JONATHAN RUBINS M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 675 W WASHINGTON ST INTERLAKES ONCOLOGY & HEMATOLOGY PC
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City | GENEVA
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State | NY
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Zip | 14456
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Country | US
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Telephone | 315-781-2250
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Fax | 315-781-0733
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Provider Business Mailing Address
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Address Line | 211 WHITE SPRUCE BLVD INTERLAKES ONCOLOGY & HEMATOLOGY PC
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City | ROCHESTER
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State | NY
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Zip | 14623
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Country | US
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Telephone | 585-475-8728
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Fax | 585-475-9411
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 116073-1
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License Number State | NY
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