1023070422 NPI number — DR. SETH M RUBIN MD

Table of content: DR. SETH M RUBIN MD (NPI 1023070422)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023070422 NPI number — DR. SETH M RUBIN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUBIN
Provider First Name:
SETH
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023070422
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2470
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLEMINGTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08822-2470
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-806-0080
Provider Business Mailing Address Fax Number:
908-806-3478

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 WALTER E FORAN BLVD STE 302
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLEMINGTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08822-4668
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-806-0080
Provider Business Practice Location Address Fax Number:
908-806-3478
Provider Enumeration Date:
04/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  25MA05897800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X , with the licence number: 25MA05897800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5558409 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1054815 . This is a "HORIZON NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1291781 . This is a "ONE HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 223702560001 . This is a "QUALCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 420424 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4486 . This is a "LOCAL 825" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1804659 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: HUP035 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8199902 . This is a "AMERIGROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1137940 . This is a "UNITED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4369724 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0662159000 . This is a "AMERIHEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1326818 . This is a "FIRST HEALTH/CCN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1K5052 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".




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