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General NPI Number Information
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NPI Number | 1356394431
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Entity Type | Individual
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Provider Name | ROBERT SAMUEL NUBA M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 05/04/2015
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Provider Practice Location Address
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Address Line | 1385 BROADWAY SUITE A31
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City | HEWLETT
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State | NY
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Zip | 11557-1364
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Country | US
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Telephone | 516-400-9015
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Fax | 516-400-9015
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Provider Business Mailing Address
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Address Line | 1385 BROADWAY A31
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City | HEWLETT
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State | NY
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Zip | 11557-1364
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Country | US
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Telephone | 516-400-9015
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Fax | 516-400-9015
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 130068
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 130068
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License Number State | NY
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