MEDICARE: RUBINO PHARMACY

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	333600000X	Pharmacy	2491	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3309831	OTHER		NCDCP

General Provider Information

NPI Number	:	1659356863
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUBINO PHARMACY

Provider Business Mailing Address
First Line	:	6602 17TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-4303
Country	:	US
Telephone Number	:	718-256-5052
Fax Number	:

Provider Business Practice Location Address
First Line	:	6602 17TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-4303
Country	:	US
Telephone Number	:	718-256-5052
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NICHOLAS RUBINO
Credential	:
Telephone Number	:	718-256-5052

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	08/22/2020

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