Provider Demographics
NPI:1649486705
Name:JABUSH, JONDAVID H (MD)
Entity type:Individual
Prefix:
First Name:JONDAVID
Middle Name:H
Last Name:JABUSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:108 BILBY RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-4174
Mailing Address - Country:US
Mailing Address - Phone:908-850-9548
Mailing Address - Fax:908-813-3256
Practice Address - Street 1:108 BILBY RD
Practice Address - Street 2:SUITE 303
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-4174
Practice Address - Country:US
Practice Address - Phone:908-850-9548
Practice Address - Fax:908-813-3256
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08250000208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery