Provider Demographics
NPI:1215961792
Name:RUBENSTEIN, RICHARD B (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:B
Last Name:RUBENSTEIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:250 PATCHOGUE YAPHANK RD
Mailing Address - Street 2:SUITE 5A
Mailing Address - City:EAST PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-4800
Mailing Address - Country:US
Mailing Address - Phone:631-475-1013
Mailing Address - Fax:631-475-5602
Practice Address - Street 1:250 PATCHOGUE YAPHANK RD
Practice Address - Street 2:SUITE 5A
Practice Address - City:EAST PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-4800
Practice Address - Country:US
Practice Address - Phone:631-475-1013
Practice Address - Fax:631-475-1092
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2012-10-24
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Provider Licenses
StateLicense IDTaxonomies
NY117134-1208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00959233Medicaid
NYW04331Medicare PIN
A01770Medicare UPIN
NY00959233Medicaid