Dr Surasak Puvabanditsin, MD | |
1 Robert Wood Johnson Pl, Meb 396, New Brunswick, NJ 08901-1928 | |
(732) 235-5691 | |
(732) 235-5668 |
Full Name | Dr Surasak Puvabanditsin |
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Gender | Male |
Speciality | Pediatrics - Neonatal-perinatal Medicine |
Location | 1 Robert Wood Johnson Pl, New Brunswick, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1235135880 | NPI | - | NPPES |
3816508 | Medicaid | NJ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080N0001X | Pediatrics - Neonatal-perinatal Medicine | 25MA04160100 (New Jersey) | Primary |
208000000X | Pediatrics | 25MA04160100 (New Jersey) | Secondary |
Entity Name | Rutgers Health-rwj Neonatology |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1295741858 PECOS PAC ID: 2961398730 Enrollment ID: O20040227000051 |
Entity Name | Rutgers Health-rwj Pediatric Critical Care |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1780766527 PECOS PAC ID: 1355390287 Enrollment ID: O20050119000070 |
Mailing Address | Practice Location Address |
---|---|
Dr Surasak Puvabanditsin, MD 32 Carriage Dr, Piscataway, NJ 08854-5968 Ph: (732) 980-9308 | Dr Surasak Puvabanditsin, MD 1 Robert Wood Johnson Pl, Meb 396, New Brunswick, NJ 08901-1928 Ph: (732) 235-5691 |
Dr. I. Mark Hiatt, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 254 Easton Ave, New Brunswick, NJ 08901 Phone: 732-745-8600 Fax: 732-249-9572 | |
Lynne Weiss, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 89 French Street, Suite 2300, New Brunswick, NJ 08901 Phone: 732-235-6230 Fax: 732-235-6620 | |
Margaret Masterson, Pediatrics Medicare: Medicare Enrolled Practice Location: 195 Little Albany St, New Brunswick, NJ 08901 Phone: 732-235-6455 Fax: 732-235-6462 | |
Lisanne Hauck, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1 Robert Wood Johnson Pl, Robert Wood Johnson University Hospital - New Brunswick, New Brunswick, NJ 08901 Phone: 732-235-7900 | |
Daniel Notterman, Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Robert Wood Johnson Pl, Robert Wood Johnson University Hospital - New Brunswick, New Brunswick, NJ 08901 Phone: 732-235-7900 | |
Minh-tu Do, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Robert Wood Johnson Pl, Meb 342, New Brunswick, NJ 08901 Phone: 732-235-7893 Fax: 732-235-9340 | |
Christoph Ohngemach, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 254 Easton Ave, New Brunswick, NJ 08901 Phone: 732-745-8600 Fax: 732-745-8725 |