Provider Demographics
NPI:1114953403
Name:BULAN, ERWIN JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:ERWIN
Middle Name:JOSEPH
Last Name:BULAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:75 MAIN ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1367
Mailing Address - Country:US
Mailing Address - Phone:973-467-9744
Mailing Address - Fax:973-467-7512
Practice Address - Street 1:75 MAIN ST
Practice Address - Street 2:SUITE 105
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1367
Practice Address - Country:US
Practice Address - Phone:973-467-9744
Practice Address - Fax:973-467-7512
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-25
Last Update Date:2013-10-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07379300208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH60390Medicare UPIN
NJ057684Medicare PIN