Basic Information
| Provider Information | |||||||||
| NPI: | 1184673907 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RUBENSTEIN | ||||||||
| FirstName: | MARC | ||||||||
| MiddleName: | SCOTT | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14 HEATHER CT | ||||||||
| Address2: | |||||||||
| City: | PLAINSBORO | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 085361949 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322970032 | ||||||||
| FaxNumber: | 7322970558 | ||||||||
| Practice Location | |||||||||
| Address1: | 3228 STATE ROUTE 27 | ||||||||
| Address2: | |||||||||
| City: | KENDALL PARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088241445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322970032 | ||||||||
| FaxNumber: | 7322970558 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 40QA00850500 | NJ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 7200022 | 01 | NJ | AETNA PROVIDER NUMBER | OTHER |