MEDICARE: MISS ALEJANDRINA RUBIO SUMICAD III NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner		NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	26NJ00072100	OTHER	NJ	LICENSE NUMBER

General Provider Information

NPI Number	:	1447339825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ALEJANDRINA RUBIO SUMICAD III NP

Provider Business Mailing Address
First Line	:	52 RAINFORD RD
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08820-2903
Country	:	US
Telephone Number	:	732-321-9019
Fax Number	:

Provider Business Practice Location Address
First Line	:	613 PARK AVE
Second Line	:
City	:	EAST ORANGE
State	:	NJ
Zip	:	07017-1905
Country	:	US
Telephone Number	:	973-676-0955
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2006
Last Update Date	:	07/08/2007

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