Provider Demographics
NPI:1063753051
Name:ABU-ALRUB, DANA (MD)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:
Last Name:ABU-ALRUB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 RIVER RD APT 208
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-3528
Mailing Address - Country:US
Mailing Address - Phone:201-424-4097
Mailing Address - Fax:
Practice Address - Street 1:1414 MAIN AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2157
Practice Address - Country:US
Practice Address - Phone:973-253-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09187300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine