Provider Demographics
NPI:1609842749
Name:BRECHER, RUBIN (MD)
Entity type:Individual
Prefix:DR
First Name:RUBIN
Middle Name:
Last Name:BRECHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1828
Mailing Address - Country:US
Mailing Address - Phone:718-851-1186
Mailing Address - Fax:718-853-8239
Practice Address - Street 1:6 MEADOW LN
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-1828
Practice Address - Country:US
Practice Address - Phone:718-851-1186
Practice Address - Fax:718-853-8239
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MAO5288500207W00000X
NY165798207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ180032200OtherRAILROAD MEDICARE
NY01168941Medicaid
NJ0730106Medicaid
NY17F411Medicare ID - Type Unspecified
NJ0730106Medicaid
NJ180032200OtherRAILROAD MEDICARE
NYD91986Medicare UPIN