Provider Demographics
NPI:1487731543
Name:BUERANO, THELMA MAPA (MD)
Entity type:Individual
Prefix:
First Name:THELMA
Middle Name:MAPA
Last Name:BUERANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:THELMA
Other - Middle Name:A
Other - Last Name:MAPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2142 ROUTE 70
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-4735
Mailing Address - Country:US
Mailing Address - Phone:732-408-9585
Mailing Address - Fax:732-408-9586
Practice Address - Street 1:2142 RT 70
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NJ
Practice Address - Zip Code:08759
Practice Address - Country:US
Practice Address - Phone:732-408-9585
Practice Address - Fax:732-408-9586
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07716200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
101946OtherOPERATING ENGINEERS LOCAL
269501OtherAMERIGROUP
8802064OtherCIGNA
P3465914OtherOXFORD
061728394OtherQUALCARE TAX ID
2K4555OtherHEALTH NET
K5613OtherHORIZON
061728394OtherTRICARE TAX ID
425250OtherAETNA HMP PCP
061728394OtherGREAT WEST TAX ID
061728394OtherMAGNACARE TAX ID
061728394OtherST BAMABAS TAX ID
7454554OtherAETNA PPO
061728394OtherHORIZON TAX ID
2409786000OtherAMERIHEALTH
2464336OtherUNITED HEALTHCARE
3647597OtherAETNA HMO
8221527OtherGHI
I19905Medicare UPIN
061728394OtherGREAT WEST TAX ID