Individual provider Active NPI

Liset Rubino, MSED

  • Specialist
  • Astoria, NY
National Provider Identifier
1154686111
Registry record updated Jul 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
837401 Issued in NY
Practice address
3711 35TH Ave
Astoria, NY 11101-1524
Phone
(718) 706-7500
NPI assigned
Jul 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 837401 NY Primary

Addresses

Primary practice location

3711 35TH Ave
Astoria, NY 11101-1524

Mailing address

36 Shortridge Dr
Mineola, NY 11501-2128
Phone (718) 877-0616

Other identifiers 1

IdentifierTypeStateIssuer
174400000XMedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
837401NYMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1154686111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 SHORTRIDGE DR",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012128",
            "telephone_number": "718-877-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 35TH AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111011524",
            "telephone_number": "718-706-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBINO",
        "first_name": "LISET",
        "name_prefix": "Mrs.",
        "credential": "MSED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-05",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "837401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174400000X",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.