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Provider Information for 1326297151



DR. KONSTANTIN RUBINOV

Gender: MALE

Individual NPI: 1326297151

Calendar Last Updated: 2008-09-17

Details

Name Value
NPI 1326297151
Enumeration Date 2008-09-17
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 295 N 7TH ST APT #2
BROOKLYN, NY 11211-2101
United States

Phone: 917-903-3108 | Fax:
View Map External Link
Primary Practice Address 8961 164TH ST
JAMAICA, NY 11432-5141
United States

Phone: 917-903-3108 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice NY 0541781