MEDICARE: DR. ROY ALAN RUBENSTEIN MD

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	174400000X	Specialist	141133	NY
2	207RP1001X	Pulmonary Disease Physician	141133	NY

General Provider Information

NPI Number	:	1679514228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROY ALAN RUBENSTEIN MD

Provider Business Mailing Address
First Line	:	920 ATLANTIC AVENUE
Second Line	:
City	:	BALDWIN HARBOR
State	:	NY
Zip	:	11510
Country	:	US
Telephone Number	:	516-623-8700
Fax Number	:	516-523-3746

Provider Business Practice Location Address
First Line	:	920 ATLANTIC AVENUE
Second Line	:
City	:	BALDWIN HARBOR
State	:	NY
Zip	:	11510
Country	:	US
Telephone Number	:	516-623-8700
Fax Number	:	516-523-3746

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	09/23/2009

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