Provider Demographics
NPI:1053441402
Name:BUGDA, DENISE J (PA C)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:J
Last Name:BUGDA
Suffix:
Gender:F
Credentials:PA C
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Mailing Address - Street 1:1650 VALLEY CENTER PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-2344
Mailing Address - Country:US
Mailing Address - Phone:484-884-4436
Mailing Address - Fax:484-884-7367
Practice Address - Street 1:32 W FOOTHILLS DR
Practice Address - Street 2:
Practice Address - City:DRUMS
Practice Address - State:PA
Practice Address - Zip Code:18222-2407
Practice Address - Country:US
Practice Address - Phone:570-788-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-10-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOA000083L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA112117Medicare PIN