Individual
DR. RUSSELL F GUBA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
220 KNICKERBOCKER ROAD, CRESSKILL, NJ 07626-1827
(201) 568-2020
(201) 568-4213
Mailing address
220 KNICKERBOCKER ROAD, 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
—
519697
MEDICARE PTAN
NJ
Enumeration date
11/03/2006
Last updated
07/28/2010
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