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Organization

RUSSELL F GUBA JR MD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RUSSELL F GUBA MD (OWNER)
(201) 568-2020
Entity
Organization

Contact information

Practice address
220 KNICKERBOCKER RD, CRESSKILL, NJ 07626-1827
(201) 568-2020
(201) 568-4213
Mailing address
220 KNICKERBOCKER RD, CRESSKILL, NJ 07626-1827
(201) 568-2020
(201) 568-4213

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MA43638
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0K4573
HEALTHNET
NJ
01
P1680384
OXFORD
NJ
Enumeration date
02/08/2007
Last updated
07/28/2010
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