MEDICARE: DR. MARSHA E RUBIN D.D.S.

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	125Q00000X	Oral Medicine Dentistry	042349	NY
2	122300000X	Dentist	042349	NY

General Provider Information

NPI Number	:	1700963535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARSHA E RUBIN D.D.S.

Provider Business Mailing Address
First Line	:	525 E 68TH ST
Second Line	:	SUITE 2132, MAILBOX 275
City	:	NEW YORK
State	:	NY
Zip	:	10021-4870
Country	:	US
Telephone Number	:	212-746-5115
Fax Number	:	212-746-8400

Provider Business Practice Location Address
First Line	:	525 E 68TH ST
Second Line	:	SUITE 2132, MAILBOX 275
City	:	NEW YORK
State	:	NY
Zip	:	10021-4870
Country	:	US
Telephone Number	:	212-746-5115
Fax Number	:	212-746-8400

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	03/01/2019

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