Provider Demographics
NPI:1992909303
Name:RUBIN, STUART BERNARD (RPH)
Entity type:Individual
Prefix:MR
First Name:STUART
Middle Name:BERNARD
Last Name:RUBIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 110840
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-0840
Mailing Address - Country:US
Mailing Address - Phone:718-387-0021
Mailing Address - Fax:718-782-0383
Practice Address - Street 1:70 LEE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-7234
Practice Address - Country:US
Practice Address - Phone:718-387-0021
Practice Address - Fax:718-782-0383
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032861183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist