Provider Demographics
NPI:1467062463
Name:LOBUGLIO, ERICA JOSEPHINE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ERICA
Middle Name:JOSEPHINE
Last Name:LOBUGLIO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 FURMAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-1711
Mailing Address - Country:US
Mailing Address - Phone:732-556-8095
Mailing Address - Fax:
Practice Address - Street 1:733 N BEERS ST STE U3
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1513
Practice Address - Country:US
Practice Address - Phone:732-556-8095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-04
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00573000363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MP00573000Medicaid