MEDICARE: DR. MOSHE RUBIN M.D.

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	207RG0100X	Gastroenterology Physician	158806	NY

General Provider Information

NPI Number	:	1134217078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOSHE RUBIN M.D.

Provider Business Mailing Address
First Line	:	1020 PARK AVE
Second Line	:	FLOOR 1
City	:	NEW YORK
State	:	NY
Zip	:	10028-0913
Country	:	US
Telephone Number	:	212-772-1012
Fax Number	:	212-772-2877

Provider Business Practice Location Address
First Line	:	1020 PARK AVE
Second Line	:	FLOOR 1
City	:	NEW YORK
State	:	NY
Zip	:	10028-0913
Country	:	US
Telephone Number	:	212-772-1012
Fax Number	:	212-772-2877

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

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	03/16/2010

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