Provider Demographics
NPI:1699957464
Name:RUBINO BACK & NECK CARE CENTER, P.C.
Entity type:Organization
Organization Name:RUBINO BACK & NECK CARE CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:RUBINO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:203-933-9404
Mailing Address - Street 1:393 CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-5013
Mailing Address - Country:US
Mailing Address - Phone:203-933-9404
Mailing Address - Fax:203-933-0272
Practice Address - Street 1:393 CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-5013
Practice Address - Country:US
Practice Address - Phone:203-933-9404
Practice Address - Fax:203-933-0272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000609111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTT22673Medicare UPIN