Provider Demographics
NPI:1699165142
Name:BUDA, ERICA
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:BUDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:BETH
Other - Last Name:BUDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:18 WILSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728
Mailing Address - Country:US
Mailing Address - Phone:732-372-9037
Mailing Address - Fax:
Practice Address - Street 1:55 US HWY 9
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3018
Practice Address - Country:US
Practice Address - Phone:732-294-5197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RW01412600183700000X, 247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other