Provider Demographics
NPI:1336118835
Name:BRAGA, GENE J (MD)
Entity Type:Individual
Prefix:DR
First Name:GENE
Middle Name:J
Last Name:BRAGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 SHORE RD
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2631
Mailing Address - Country:US
Mailing Address - Phone:609-653-4343
Mailing Address - Fax:609-601-9630
Practice Address - Street 1:229 SHORE RD
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2631
Practice Address - Country:US
Practice Address - Phone:609-653-4343
Practice Address - Fax:609-601-9630
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA52731208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1209205Medicaid
NJE51541Medicare UPIN
NHBR572769Medicare ID - Type Unspecified