Provider Demographics
NPI:1154697472
Name:RUBINOV, JASON (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:RUBINOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-3933
Mailing Address - Country:US
Mailing Address - Phone:718-210-2960
Mailing Address - Fax:718-744-9374
Practice Address - Street 1:2569 OCEAN AVENUE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229
Practice Address - Country:US
Practice Address - Phone:718-210-2960
Practice Address - Fax:718-744-9374
Is Sole Proprietor?:No
Enumeration Date:2012-03-30
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY280210207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology