1487709093 NPI number — DEBORAH J BUCSEK APN C

Table of content: DEBORAH J BUCSEK APN C (NPI 1487709093)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487709093 NPI number — DEBORAH J BUCSEK APN C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BUCSEK
Provider First Name:
DEBORAH
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APN C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487709093
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
136 CEDAR BRIDGE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WOODBINE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08270-9112
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-427-6096
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
408 BETHEL ROAD SUITE E
Provider Second Line Business Practice Location Address:
JERSEY SHORE GASTROENTEROLOGY ASSOCIATES PA
Provider Business Practice Location Address City Name:
SOMERS POINT
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-926-3330
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/24/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  26NR06796500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2200X , with the licence number: 26NJ00118400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)