Provider Demographics
NPI:1124223086
Name:COBA, MIGUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:
Last Name:COBA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 RAHWAY AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-3481
Mailing Address - Country:US
Mailing Address - Phone:732-527-0770
Mailing Address - Fax:732-218-5872
Practice Address - Street 1:477 RAHWAY AVE
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-3481
Practice Address - Country:US
Practice Address - Phone:732-527-0770
Practice Address - Fax:732-218-5872
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY278190208100000X
NJ25MA08997000208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation