Basic Information
| Provider Information | |||||||||
| NPI: | 1861484255 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUBOW | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | H. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 416457 | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 022416457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8443621735 | ||||||||
| FaxNumber: | 9732907495 | ||||||||
| Practice Location | |||||||||
| Address1: | 312 APPLEGARTH RD STE 107 | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088315347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6093952939 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2005 | ||||||||
| LastUpdateDate: | 09/02/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 2006-00466 | NC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0300X | 25MA03655500 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | 208000000X | 25MA03655500 | NJ | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 2006-00466 | NC | N | Allopathic & Osteopathic Physicians | Pediatrics | 207R00000X | 25MA03655500 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.