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General NPI Number Information
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NPI Number | 1750096210
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Entity Type | Individual
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Provider Name | SOPHIA GABRIELLE RUBENSTEIN CPNP-AC
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Gender | Female
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Dates
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Enumeration Date | 01/19/2023
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Last Update Date | 01/19/2023
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Provider Practice Location Address
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Address Line | 3401 CIVIC CENTER BLVD
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4319
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Country | US
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Telephone | 215-590-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 2046 FEDERAL ST APT 3
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City | PHILADELPHIA
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State | PA
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Zip | 19146-4372
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Country | US
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Telephone | 615-512-0256
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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 | 363LP0222X
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Taxonomy Name | Critical Care Pediatric Nurse Practitioner
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License Number | SP026801
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License Number State | PA
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