MEDICARE: DIANA RUBENSTEIN OTR/L

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	225X00000X	Occupational Therapist	016190	NY

General Provider Information

NPI Number	:	1508175167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA RUBENSTEIN OTR/L

Provider Business Mailing Address
First Line	:	3052 BRIGHTON 1ST STREET
Second Line	:	APT 3E
City	:	BROOKLYN
State	:	NY
Zip	:	11235-4660
Country	:	US
Telephone Number	:	917-615-4074
Fax Number	:

Provider Business Practice Location Address
First Line	:	3052 BRIGHTON 1ST ST
Second Line	:	APT 3E
City	:	BROOKLYN
State	:	NY
Zip	:	11235-8088
Country	:	US
Telephone Number	:	917-615-4074
Fax Number	:

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

Provider Enumeration Date	:	09/30/2010
Last Update Date	:	12/23/2013

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