Provider Demographics
NPI:1568416352
Name:BUGAY, VICTOR (MD)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:BUGAY
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 1:1163 RTE 37 W STE D4
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-4975
Mailing Address - Country:US
Mailing Address - Phone:732-341-9494
Mailing Address - Fax:732-341-3416
Practice Address - Street 1:1163 RTE 37 W STE D4
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-4975
Practice Address - Country:US
Practice Address - Phone:732-341-9494
Practice Address - Fax:732-341-3416
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07713200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0081141Medicaid
NJ0081141Medicaid
NJ086740L4LMedicare ID - Type Unspecified