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General NPI Number Information
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NPI Number | 1710545959
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Entity Type | Individual
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Provider Name | SIMONE GABRIELLE RUBIN DO
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Gender | Female
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Dates
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Enumeration Date | 06/03/2019
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 50 ESSEX ST STE 5
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City | ROCHELLE PARK
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State | NJ
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Zip | 07662-4341
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Country | US
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Telephone | 201-843-3152
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Fax |
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Provider Business Mailing Address
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Address Line | 15 ESSEX RD
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City | PARAMUS
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State | NJ
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Zip | 07652-1451
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Country | US
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Telephone | 201-291-6000
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 25MB11414000
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License Number State | NJ
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