MEDICARE: MARTIN RUBEL M.D

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	2084P0800X	Psychiatry Physician	MD-027417-L	PA

General Provider Information

NPI Number	:	1952310377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTIN RUBEL M.D

Provider Business Mailing Address
First Line	:	220 W RITTENHOUSE SQ
Second Line	:	APT. 23A
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-5737
Country	:	US
Telephone Number	:	215-731-9606
Fax Number	:

Provider Business Practice Location Address
First Line	:	135 S 19TH ST
Second Line	:	SUITE 230
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-4912
Country	:	US
Telephone Number	:	215-561-4440
Fax Number	:	215-563-7255

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

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	07/08/2007

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