Provider Demographics
NPI:1265628614
Name:MARK J RUBINETTI MD LLC
Entity Type:Organization
Organization Name:MARK J RUBINETTI MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:RUBINETTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-927-2888
Mailing Address - Street 1:20 COMMERCE BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876-1348
Mailing Address - Country:US
Mailing Address - Phone:973-927-2888
Mailing Address - Fax:973-927-2808
Practice Address - Street 1:20 COMMERCE BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1348
Practice Address - Country:US
Practice Address - Phone:973-927-2888
Practice Address - Fax:973-927-2808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA55055207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty