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General NPI Number Information
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NPI Number | 1922391564
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Entity Type | Organization
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Legal Business Name | BARRY RUBIN M.D.,P.C.
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Dates
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Enumeration Date | 05/16/2011
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Last Update Date | 07/02/2013
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Provider Practice Location Address
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Address Line | 46 ROUTE 25A STE 4
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City | SETAUKET
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State | NY
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Zip | 11733-2820
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Country | US
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Telephone | 631-246-9501
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Fax | 631-246-9570
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Provider Business Mailing Address
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Address Line | 46 ROUTE 25A STE 4
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City | EAST SETAUKET
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State | NY
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Zip | 11733
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Country | US
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Telephone | 631-246-9501
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Fax | 631-246-9570
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Authorized Official
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Title or Position | PRESIDENT/PHYSICIAN
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Name | DR. BARRY RUBIN
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Credential | M.D.
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Telephone | 631-246-9501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 1697941
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License Number State | NY
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