Provider Demographics
NPI:1144025941
Name:RUBIN, LEAH (OT/RL)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:RUBIN
Suffix:
Gender:F
Credentials:OT/RL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HOLLY LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1317
Mailing Address - Country:US
Mailing Address - Phone:516-778-4192
Mailing Address - Fax:
Practice Address - Street 1:444 BEACH 6TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-5697
Practice Address - Country:US
Practice Address - Phone:718-471-8444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029854225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist