MEDICARE: JARED JAMES RUBAN LMT

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	225700000X	Massage Therapist	18KT00307800	NJ

General Provider Information

NPI Number	:	1821984469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JARED JAMES RUBAN LMT

Provider Business Mailing Address
First Line	:	170 KINNELON RD
Second Line	:	SUITE 8
City	:	KINNELON
State	:	NJ
Zip	:	07405
Country	:	US
Telephone Number	:	973-908-8335
Fax Number	:

Provider Business Practice Location Address
First Line	:	170 KINNELON RD STE 8
Second Line	:
City	:	KINNELON
State	:	NJ
Zip	:	07405-2347
Country	:	US
Telephone Number	:	973-908-8335
Fax Number	:

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

Provider Enumeration Date	:	06/17/2025
Last Update Date	:	06/17/2025

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