Provider Demographics
NPI:1063556371
Name:ONG, RUBEN T (MD)
Entity type:Individual
Prefix:
First Name:RUBEN
Middle Name:T
Last Name:ONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4228 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:YARDVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08620-2105
Mailing Address - Country:US
Mailing Address - Phone:609-585-2421
Mailing Address - Fax:609-585-8888
Practice Address - Street 1:4228 S BROAD ST
Practice Address - Street 2:
Practice Address - City:YARDVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08620-2105
Practice Address - Country:US
Practice Address - Phone:609-585-2421
Practice Address - Fax:609-585-8888
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02440900207Q00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
35424OtherUNIVERSITY HEALTHPLANS
NJ33480OtherAETNA USHC
NJ91000782800OtherAMERICHOICE
NJ0083924000OtherAMERIHEALTH-KEYSTONE
P874283OtherOXFORD
NJ1105614OtherHORIZON NJ HEALTH
NJ2739607Medicaid
NJJ37848OtherHEALTHNET
NJ146763Medicare PIN
NJ91000782800OtherAMERICHOICE