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General NPI Number Information
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NPI Number | 1801821061
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Entity Type | Individual
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Provider Name | SUSAN W RUBINOFF MD
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Gender | Female
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 03/08/2021
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Provider Practice Location Address
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Address Line | 350 BOULEVARD
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City | PASSAIC
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State | NJ
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Zip | 07055-2840
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Country | US
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Telephone | 973-365-4450
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Fax | 973-916-2033
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Provider Business Mailing Address
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Address Line | 1 NORTHGATE APT 2B
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City | BRONXVILLE
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State | NY
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Zip | 10708-2613
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Country | US
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Telephone | 201-694-8569
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Fax | 973-916-2033
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 05277700
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License Number State | NJ
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