1508918806 NPI number — JOHN TUBEY III MA

Table of content: JOHN TUBEY III MA (NPI 1508918806)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508918806 NPI number — JOHN TUBEY III MA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TUBEY
Provider First Name:
JOHN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
III
Provider Credential Text:
MA
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:
1508918806
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21 GREENRIDGE CIRCLE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18940
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-968-4586
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6 WHITE HORSE PIKE
Provider Second Line Business Practice Location Address:
SUITE 1B 205A FOURTH AVE
Provider Business Practice Location Address City Name:
HADDON HEIGHTS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-672-1900
Provider Business Practice Location Address Fax Number:
856-672-9019
Provider Enumeration Date:
01/17/2007

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: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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