Provider Demographics
NPI:1396812418
Name:BUGLIONE, KATHLEEN B (FNPC)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:B
Last Name:BUGLIONE
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:161 RIVERSIDE DR
Mailing Address - Street 2:SUITE 109
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-4176
Mailing Address - Country:US
Mailing Address - Phone:607-770-7074
Mailing Address - Fax:607-770-3452
Practice Address - Street 1:161 RIVERSIDE DR
Practice Address - Street 2:SUITE 109
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-4176
Practice Address - Country:US
Practice Address - Phone:607-770-7074
Practice Address - Fax:607-770-3452
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY330416363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
S51246Medicare UPIN
BB6295Medicare ID - Type Unspecified