Provider Demographics
NPI:1679534341
Name:RUBIN, ANN (NP-C)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:RUBIN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 KRESSON RD
Mailing Address - Street 2:SUITE #101
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-3200
Mailing Address - Country:US
Mailing Address - Phone:856-428-4100
Mailing Address - Fax:856-428-5748
Practice Address - Street 1:63 KRESSON RD
Practice Address - Street 2:SUITE #101
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-3200
Practice Address - Country:US
Practice Address - Phone:856-428-4100
Practice Address - Fax:856-428-5748
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN06910900363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q20224Medicare UPIN
NJ081336AFEMedicare PIN