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General NPI Number Information
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NPI Number | 1316240526
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Entity Type | Individual
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Provider Name | JEFFREY B RUBIN LCSW, PH.D.
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Gender | Male
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Dates
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Enumeration Date | 12/09/2010
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 1841 BROADWAY RM 711
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City | NEW YORK
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State | NY
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Zip | 10023-7666
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Country | US
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Telephone | 212-664-0751
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Fax |
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Provider Business Mailing Address
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Address Line | 66 MAIN STREET
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City | BEDFORD HILLS
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State | NY
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Zip | 10507
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Country | US
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Telephone | 914-242-0229
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | PRO216221
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License Number State | NY
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