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NPI Code Detail

MEDICARE: RUTGERS

MEDICARE: RUTGERS
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1922941236
Entity Type Code : Organization
Provider Name (Legal Business Name) : RUTGERS
Provider Business Mailing Address
First Line : 94 OLD SHORT HILLS RD
Second Line :
City : LIVINGSTON
State : NJ
Zip : 07039-5672
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 94 OLD SHORT HILLS RD
Second Line :
City : LIVINGSTON
State : NJ
Zip : 07039-5672
Country : US
Telephone Number : 973-322-5000
Fax Number :
Authorized Official
Title or Position : PROGRAM DIRECTOR
Name : LISA POMPEO
Credential : MD
Telephone Number : 732-445-4636
Provider Enumeration Date : 04/11/2026
Last Update Date : 04/11/2026

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Directions to “RUTGERS ” Practice Location

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