Provider Demographics
NPI:1770357865
Name:RUBINO, LUCIANA NICOLE (MS SLP)
Entity type:Individual
Prefix:
First Name:LUCIANA
Middle Name:NICOLE
Last Name:RUBINO
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 KUSER RD STE A2
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3828
Mailing Address - Country:US
Mailing Address - Phone:973-294-8266
Mailing Address - Fax:
Practice Address - Street 1:1540 KUSER RD STE A2
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3828
Practice Address - Country:US
Practice Address - Phone:609-570-5544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTL-4238235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist