MEDICARE: SARAH RUBINROTT DNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	405209	NY
2	163W00000X	Registered Nurse	774960	NY

General Provider Information

NPI Number	:	1821871526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH RUBINROTT DNP

Provider Business Mailing Address
First Line	:	2240 PEE DEE RD
Second Line	:
City	:	NORTH JAVA
State	:	NY
Zip	:	14113-9746
Country	:	US
Telephone Number	:	585-943-0670
Fax Number	:

Provider Business Practice Location Address
First Line	:	2240 PEE DEE RD
Second Line	:
City	:	NORTH JAVA
State	:	NY
Zip	:	14113-9746
Country	:	US
Telephone Number	:	585-943-0670
Fax Number	:

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

Provider Enumeration Date	:	08/16/2023
Last Update Date	:	08/16/2023

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