MEDICARE: MRS. SHLOMIT RUBIN LCSW

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	1041C0700X	Clinical Social Worker	059296-1	NY

General Provider Information

NPI Number	:	1184711145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHLOMIT RUBIN LCSW

Provider Business Mailing Address
First Line	:	704 WASHINGTON ST APT 4A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10014-2334
Country	:	US
Telephone Number	:	212-255-5318
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 E 36TH ST APT 1H
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-3423
Country	:	US
Telephone Number	:	212-255-5318
Fax Number	:

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

Provider Enumeration Date	:	10/09/2006
Last Update Date	:	07/08/2007

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