Provider Demographics
NPI:1831267509
Name:RUBENSTEIN, STEPHEN (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:RUBENSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 PARK AVE
Mailing Address - Street 2:APT 17E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5047
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:885 PARK AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0383
Practice Address - Country:US
Practice Address - Phone:212-737-6993
Practice Address - Fax:212-784-7295
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113928207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY13-3515505OtherGREAT-WEST
NY13-3515505OtherCHOICECARE PPO (HUMANA)
NY0000525-02OtherAMERICHOICE
NY3182775 & 4339758OtherAETNA HMO & PPO
NY6528975OtherCIGNA
NY569P21OtherEMPIRE BCBS
NYB80007Medicare UPIN
NY75979VMedicare ID - Type UnspecifiedGHI
NY958621Medicare ID - Type Unspecified
NY958621Medicare ID - Type UnspecifiedEMPIRE