Individual
MR. KENNETH P RUBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
420 GRAND AVE, SUITE 101, ENGLEWOOD, NJ 07631-4152
(201) 569-7044
(201) 569-1999
Mailing address
420 GRAND AVE, SUITE 101, ENGLEWOOD, NJ 07631-4152
(201) 569-7044
(201) 569-1999
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
25MA04043000
NJ
207RG0100X
Gastroenterology Physician
131904-1
NY
207RG0100X
Gastroenterology Physician
Primary
25MA04043000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0062833
GHI
NJ
05
—
1566300
—
NJ
01
—
56A411
EMPIRE HEALTH PLAN
NJ
01
—
60833
AETNA US HEALTHCARE
NJ
01
—
BP377
OCFORD HEALTH PLAN
NJ
01
—
OK2493
HEALTHNET
NJ
Enumeration date
05/19/2006
Last updated
12/15/2025
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