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Individual

ROBERT SAMUEL NUBA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1385 BROADWAY, SUITE A31, HEWLETT, NY 11557-1364
(516) 400-9015
(516) 400-9015
Mailing address
1385 BROADWAY, A31, HEWLETT, NY 11557-1364
(516) 400-9015
(516) 400-9015

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
130068
NY
208D00000X
General Practice Physician
130068
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00593260
NY
01
49A071
MEDICARE ID
NY
Enumeration date
05/18/2006
Last updated
05/04/2015
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