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General NPI Number Information
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NPI Number | 1740271998
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Entity Type | Individual
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Provider Name | RONALD J POBLETE MD
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Gender | Male
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Dates
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Enumeration Date | 11/04/2005
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Last Update Date | 05/16/2013
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Provider Practice Location Address
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Address Line | 289 MARKET ST SUITE 2
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City | SADDLE BROOK
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State | NJ
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Zip | 07663-6048
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Country | US
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Telephone | 201-587-9204
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Fax | 201-587-0623
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Provider Business Mailing Address
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Address Line | 502 HAMBURG TPKE SUITE 108
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City | WAYNE
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State | NJ
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Zip | 07470-8431
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Country | US
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Telephone | 973-942-5224
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Fax | 973-942-7443
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA05479500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 25MA05479500
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License Number State | NJ
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