Provider Demographics
NPI:1902921117
Name:DR. ELIZABETH ANN RUBERG PC
Entity Type:Organization
Organization Name:DR. ELIZABETH ANN RUBERG PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RUBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:412-262-1160
Mailing Address - Street 1:1136 THORN RUN RD STE L
Mailing Address - Street 2:
Mailing Address - City:MOON TWP
Mailing Address - State:PA
Mailing Address - Zip Code:15108-4301
Mailing Address - Country:US
Mailing Address - Phone:412-262-1160
Mailing Address - Fax:412-262-1919
Practice Address - Street 1:1136 THORN RUN RD STE L
Practice Address - Street 2:
Practice Address - City:MOON TWP
Practice Address - State:PA
Practice Address - Zip Code:15108-4301
Practice Address - Country:US
Practice Address - Phone:412-262-1160
Practice Address - Fax:412-262-1919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
063569Medicare ID - Type Unspecified