Provider Demographics
NPI:1538592241
Name:RUBIN-BOSCO, JUDI F (MA, MT-BC, LCAT)
Entity type:Individual
Prefix:MS
First Name:JUDI
Middle Name:F
Last Name:RUBIN-BOSCO
Suffix:
Gender:F
Credentials:MA, MT-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 2ND AVE
Mailing Address - Street 2:22
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:646-325-6910
Mailing Address - Fax:
Practice Address - Street 1:145 2ND AVE
Practice Address - Street 2:22
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:646-325-6910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000893-1225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist