Provider Demographics
NPI:1356573562
Name:RUBEL, LAURIE C (MSN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:C
Last Name:RUBEL
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:C
Other - Last Name:LYCKSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:280 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-4816
Mailing Address - Country:US
Mailing Address - Phone:212-227-8401
Mailing Address - Fax:212-227-8842
Practice Address - Street 1:280 HENRY ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-4816
Practice Address - Country:US
Practice Address - Phone:212-227-8401
Practice Address - Fax:212-227-8842
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF335857363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily