Basic Information
| Provider Information | |||||||||
| NPI: | 1770945123 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RUBIN | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | JILL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7444 SAINT CHARLES AVE APT 202 | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701183866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2153780212 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2400 CANAL ST | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701196535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8009358387 | ||||||||
| FaxNumber: | 5045076111 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2016 | ||||||||
| LastUpdateDate: | 06/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 323155 | LA | N | Allopathic & Osteopathic Physicians | Pediatrics | 207R00000X | 323155 | LA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.