Provider Demographics
NPI:1063255958
Name:RUBINO, AMANDA (MA)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:RUBINO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 CREEKSIDE DR # 108
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2038
Mailing Address - Country:US
Mailing Address - Phone:716-810-7700
Mailing Address - Fax:
Practice Address - Street 1:165 CREEKSIDE DR # 108
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2038
Practice Address - Country:US
Practice Address - Phone:716-810-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist