Provider Demographics
NPI:1588974679
Name:BUGA, ALIONA (PA)
Entity type:Individual
Prefix:
First Name:ALIONA
Middle Name:
Last Name:BUGA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 1ST AVE
Mailing Address - Street 2:SUITE 113
Mailing Address - City:ATLANTIC HIGHLANDS
Mailing Address - State:NJ
Mailing Address - Zip Code:07716-1284
Mailing Address - Country:US
Mailing Address - Phone:732-872-2007
Mailing Address - Fax:
Practice Address - Street 1:25 1ST AVE
Practice Address - Street 2:SUITE 113
Practice Address - City:ATLANTIC HIGHLANDS
Practice Address - State:NJ
Practice Address - Zip Code:07716-1284
Practice Address - Country:US
Practice Address - Phone:732-872-2007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014088363A00000X
NJ25MP00241100363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant