Basic Information
| Provider Information | |||||||||
| NPI: | 1407960990 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RUBENSTEIN | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 56 FRANKLIN ST. | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | WATERBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 067061253 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037098873 | ||||||||
| FaxNumber: | 2037099873 | ||||||||
| Practice Location | |||||||||
| Address1: | 70 HEMINWAY PARK RD | ||||||||
| Address2: | |||||||||
| City: | WATERTOWN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 067952612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8609453350 | ||||||||
| FaxNumber: | 8609453251 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2006 | ||||||||
| LastUpdateDate: | 10/28/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 15816 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0100927 | 01 | AETNA | OTHER | 76345 | 01 | CT | AMERICHOICE | OTHER | 127709 | 01 | CT | WELLCARE | OTHER | 110170614 | 01 | CT | RAILROAD MEDICARE | OTHER | 1143356 | 01 | CT | USA | OTHER | 756284 | 01 | CT | CONNECTICARE | OTHER | 010015816CT01 | 01 | CT | ANTHEM | OTHER | 0R3234 | 01 | CT | HEALTHNET | OTHER | 4112895 | 01 | CT | AETNA | OTHER | P4203159 | 01 | CT | OXFORD | OTHER | 004230075 | 05 | CT | MEDICAID | P00964312 | 01 | CT | RR MEDICARE | OTHER | 3V5929 | 01 | CT | HEALTHNET/COMMERCIAL | OTHER |