Provider Demographics
NPI:1932292000
Name:CECERE & RUBINO INTERNAL MEDICINE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:CECERE & RUBINO INTERNAL MEDICINE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CECERE
Authorized Official - Suffix:
Authorized Official - Credentials:MD,FACP
Authorized Official - Phone:973-471-4004
Mailing Address - Street 1:1195 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3621
Mailing Address - Country:US
Mailing Address - Phone:973-471-4004
Mailing Address - Fax:973-471-1180
Practice Address - Street 1:1195 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3621
Practice Address - Country:US
Practice Address - Phone:973-471-4004
Practice Address - Fax:973-471-1180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0600154061207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DA4041OtherPALMETTO GBA - RAILROAD MEDICARE
NJ9005803Medicaid
NJ9005803Medicaid