Provider Demographics
NPI:1710950639
Name:BRUG, PAMELA (MD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:BRUG
Suffix:
Gender:F
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:RARITAN BAY MEDICAL CENTER - DEPT. OB&GYN
Mailing Address - Street 2:530 NEW BRUNSWICK AVE
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861
Mailing Address - Country:US
Mailing Address - Phone:732-324-6065
Mailing Address - Fax:732-324-6063
Practice Address - Street 1:RARITAN BAY MEDICAL CENTER - DEPT. OB&GYN
Practice Address - Street 2:530 NEW BRUNSWICK AVE
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861
Practice Address - Country:US
Practice Address - Phone:732-324-6065
Practice Address - Fax:732-324-6063
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA058810207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ44459OtherAMERIGROUP
NJ5838457OtherAETNA PPO
NJ2841357000OtherAMERIHEALTH#
NJ91002215200OtherAMERICHOICE#
NJ6517404OtherMEDICAID HEALTHSTART #
NJ14945OtherUNIVERSITY HEALTH PLANS#
NJ3K5318OtherHEALTHNET#
NJ1149978OtherAETNA HMO
NJ60023562OtherHORIZON NJ HEALTH#
NJP3657176OtherOXFORD#
NJ8224340OtherGHI PPO
NJ83N201OtherEMPIRE BCBS
NJ2841357000OtherAMERIHEALTH#
NJ60023562OtherHORIZON NJ HEALTH#