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General NPI Number Information
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NPI Number | 1912248196
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Entity Type | Individual
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Provider Name | RUBI MARCONI DDS
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Gender | Female
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Dates
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Enumeration Date | 03/12/2013
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Last Update Date | 09/09/2013
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Provider Practice Location Address
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Address Line | 3439 VESTAL PKWY E
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City | VESTAL
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State | NY
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Zip | 13850-2147
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Country | US
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Telephone | 607-798-8011
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Fax |
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Provider Business Mailing Address
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Address Line | 20960 45TH DR
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City | BAYSIDE
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State | NY
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Zip | 11361-3232
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Country | US
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Telephone | 718-704-3126
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02530100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 056965
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License Number State | NY
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