Provider Demographics
NPI:1245375286
Name:RUBINO, DOMINIC JUDE (DC)
Entity type:Individual
Prefix:DR
First Name:DOMINIC
Middle Name:JUDE
Last Name:RUBINO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7601 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3303
Mailing Address - Country:US
Mailing Address - Phone:718-748-9624
Mailing Address - Fax:929-233-7398
Practice Address - Street 1:3650 US HIGHWAY 9W STE I
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:NY
Practice Address - Zip Code:12528-2037
Practice Address - Country:US
Practice Address - Phone:845-691-9100
Practice Address - Fax:845-691-9477
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009840-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU84735Medicare UPIN
NYX3Z061Medicare PIN