MEDICARE: DEVORAH RUBENSTEIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	0759641	NY

General Provider Information

NPI Number	:	1043498488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEVORAH RUBENSTEIN

Provider Business Mailing Address
First Line	:	3312-10 SURF AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224
Country	:	US
Telephone Number	:	718-372-3300
Fax Number	:	718-996-8758

Provider Business Practice Location Address
First Line	:	3312 AVENUE N # 10S
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-2645
Country	:	US
Telephone Number	:	718-372-3300
Fax Number	:	718-996-8758

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2008
Last Update Date	:	02/07/2008

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