Provider Demographics
NPI:1912099797
Name:FEBRES, RUBEN ANTONIO (MS)
Entity type:Individual
Prefix:MR
First Name:RUBEN
Middle Name:ANTONIO
Last Name:FEBRES
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 ALLEN ST APT B
Mailing Address - Street 2:
Mailing Address - City:NETCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07857-1204
Mailing Address - Country:US
Mailing Address - Phone:908-687-1788
Mailing Address - Fax:908-687-0294
Practice Address - Street 1:43 PROGRESS ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-8114
Practice Address - Country:US
Practice Address - Phone:908-687-7188
Practice Address - Fax:908-687-0294
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NJ37LC00128900101YA0400X
NJ312101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health