Provider Demographics
NPI:1336345321
Name:RUBIN, LOWELL J (MD)
Entity type:Individual
Prefix:DR
First Name:LOWELL
Middle Name:J
Last Name:RUBIN
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 1:85 POWER ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-1013
Mailing Address - Country:US
Mailing Address - Phone:401-861-2020
Mailing Address - Fax:401-274-6511
Practice Address - Street 1:85 POWER ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-1013
Practice Address - Country:US
Practice Address - Phone:401-861-2020
Practice Address - Fax:401-274-6511
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI05371 M.D.2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry