Provider Demographics
NPI:1275743106
Name:SUBIN-SCHNEEBAUM, REBECCA ILENE (DMD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ILENE
Last Name:SUBIN-SCHNEEBAUM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:ILENE
Other - Last Name:SUBIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:230 BRINCKERHOFF CT # 0
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-3103
Mailing Address - Country:US
Mailing Address - Phone:201-871-3093
Mailing Address - Fax:
Practice Address - Street 1:20 W IVY LN
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2121
Practice Address - Country:US
Practice Address - Phone:201-567-7766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ143651223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics