Individual
DR. JERRY A RUBANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 HOSPITAL RD STE 106, EAST PATCHOGUE, NY 11772-8811
(631) 228-5800
(929) 455-9828
Mailing address
100 HOSPITAL RD STE 106, EAST PATCHOGUE, NY 11772-8811
(631) 228-5800
(929) 455-9828
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
261957
NY
2086S0102X
Surgical Critical Care Physician
Primary
261957
NY
2086S0127X
Trauma Surgery Physician
261957
NY
Other
Enumeration date
06/10/2008
Last updated
05/16/2022
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