Healthcare Provider Details

I. General information

NPI: 1639492135
Provider Name (Legal Business Name): RUBEN T ONG MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2010
Last Update Date: 03/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4228 S BROAD ST
YARDVILLE NJ
08620-2105
US

IV. Provider business mailing address

4228 S BROAD ST
YARDVILLE NJ
08620-2105
US

V. Phone/Fax

Practice location:
  • Phone: 609-585-2421
  • Fax: 609-585-8888
Mailing address:
  • Phone: 609-585-2421
  • Fax: 609-585-8888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number25MA02440900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA02440900
License Number StateNJ

VIII. Authorized Official

Name: DR. RUBEN T ONG
Title or Position: MD
Credential: MD
Phone: 609-585-2421