Provider Demographics
NPI:1427074756
Name:ROUBIS, DIMETRIS (PA)
Entity type:Individual
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First Name:DIMETRIS
Middle Name:
Last Name:ROUBIS
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Gender:M
Credentials:PA
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Mailing Address - Street 1:1 HOLLOW LN
Mailing Address - Street 2:SUITE 110-NORTH SHORE ALLERGY & ASTHMA INSTITUTE
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1215
Mailing Address - Country:US
Mailing Address - Phone:516-365-6666
Mailing Address - Fax:516-869-1123
Practice Address - Street 1:1 HOLLOW LN
Practice Address - Street 2:SUITE 110-NORTH SHORE ALLERGY & ASTHMA INSTITUTE
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1215
Practice Address - Country:US
Practice Address - Phone:516-365-6666
Practice Address - Fax:516-869-1123
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2010-12-21
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Provider Licenses
StateLicense IDTaxonomies
NY005795363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant