Healthcare Provider Details

I. General information

NPI: 1851401996
Provider Name (Legal Business Name): ELSA B RUBIO D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1273 BOUND BROOK RD SUITE 9
MIDDLESEX NJ
08846-1490
US

IV. Provider business mailing address

87 BRIAR WAY
NESHANIC STATION NJ
08853
US

V. Phone/Fax

Practice location:
  • Phone: 732-271-7703
  • Fax: 732-271-7748
Mailing address:
  • Phone: 732-271-7703
  • Fax: 732-271-7748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: