Basic Information
| Provider Information | |||||||||
| NPI: | 1750680294 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RUBIN | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6171 EXECUTIVE BLVD | ||||||||
| Address2: | |||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208523901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028886731 | ||||||||
| FaxNumber: | 2028515739 | ||||||||
| Practice Location | |||||||||
| Address1: | 6171 EXECUTIVE BLVD | ||||||||
| Address2: | |||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208523901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028886731 | ||||||||
| FaxNumber: | 2028515739 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2011 | ||||||||
| LastUpdateDate: | 01/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | MD045161 | DC | N | Allopathic & Osteopathic Physicians | Urology | 208800000X | D0083413 | MD | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Urology |
No ID Information.