MEDICARE: DR. NEAL DAVID RUBIN DDS

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	1223G0001X	General Practice Dentistry	028151	NY

General Provider Information

NPI Number	:	1881689776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEAL DAVID RUBIN DDS

Provider Business Mailing Address
First Line	:	7503 MAIN ST
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11367-2420
Country	:	US
Telephone Number	:	718-268-4535
Fax Number	:	718-268-4559

Provider Business Practice Location Address
First Line	:	7503 MAIN ST
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11367-2420
Country	:	US
Telephone Number	:	718-268-4535
Fax Number	:	718-268-4559

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

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	07/08/2007

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