MEDICARE: DR. NANCY BETH RUBENSTEIN 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	2084P0800X	Psychiatry Physician	159507	NY
2	2084P0804X	Child & Adolescent Psychiatry Physician	159507	NY

General Provider Information

NPI Number	:	1578743365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NANCY BETH RUBENSTEIN M.D.

Provider Business Mailing Address
First Line	:	80 WALL ST
Second Line	:	SUITE 217
City	:	NEW YORK
State	:	NY
Zip	:	10005-3601
Country	:	US
Telephone Number	:	212-785-3150
Fax Number	:	212-785-7363

Provider Business Practice Location Address
First Line	:	80 WALL ST
Second Line	:	SUITE 217
City	:	NEW YORK
State	:	NY
Zip	:	10005-3601
Country	:	US
Telephone Number	:	212-785-3150
Fax Number	:	212-785-7363

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

Provider Enumeration Date	:	11/08/2007
Last Update Date	:	11/08/2007

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