| Doctor Name: | MR. MARCO A RUBIO |
| NPI Number: | 1134415896 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | OPTICIAN |
| License Number: | 001627 |
| Business Practice Address: | 69 Prospect Hill Rd East Windsor, CT - 060883600 |
| Business Phone Number: | 8606237910 |
| Business Fax Number: | 8606276433 |
| Mailing Address: | 69 Prospect Hill Rd, EAST WINDSOR |
| State: | CT |
| Postal Code: | 060883600 |
| Phone Number: | 8606237910 |
| Fax Number: | 8606276433 |
| NPI Enumeration Date: | 06/21/2011 |
| NPI Last Update Date: | 06/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1202X |
| License Number: | 001627 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optometric Technician |
| Taxonomy Definition: | |