MEDICARE: BRIAN D RUBIN 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	207R00000X	Internal Medicine Physician	151753	NY

General Provider Information

NPI Number	:	1871678631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN D RUBIN MD

Provider Business Mailing Address
First Line	:	15 COBB AVE
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10606-3601
Country	:	US
Telephone Number	:	718-920-5813
Fax Number	:	718-653-5338

Provider Business Practice Location Address
First Line	:	ADULT MEDICINE PRACTICE
Second Line	:	3444 KOSSUTH AVENUE, 5TH FL.
City	:	BRONX
State	:	NY
Zip	:	10467
Country	:	US
Telephone Number	:	718-920-5813
Fax Number	:

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

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	07/08/2007

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