Provider Demographics
NPI:1447339825
Name:SUMICAD, ALEJANDRINA RUBIO III (NP)
Entity type:Individual
Prefix:MISS
First Name:ALEJANDRINA
Middle Name:RUBIO
Last Name:SUMICAD
Suffix:III
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 RAINFORD RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2903
Mailing Address - Country:US
Mailing Address - Phone:732-321-9019
Mailing Address - Fax:
Practice Address - Street 1:613 PARK AVE
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017-1905
Practice Address - Country:US
Practice Address - Phone:973-676-0955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NJ00072100OtherLICENSE NUMBER
NJ085456MLYMedicare ID - Type Unspecified