Individual
GUSTAVO BAUZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
125 PATERSON STREET SUITE 6300, ROBERT WOOD JOHNSON MEDICAL SCHOOL DIVISION OF ACS, NEW BRUNSWICK, NJ 08901
(732) 235-7766
Mailing address
1 RICHMOND ST, APT 4106, NEW BRUNSWICK, NJ 08901-4100
(787) 948-8262
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
25MA09862800
NJ
2086S0102X
Surgical Critical Care Physician
Primary
25MA09862800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
249589
MASSACHUSETTS MEDICAL LICENSE
MA
01
—
25MA09862800
NEW JERSEY MEDICAL LICENSE
NJ
Enumeration date
06/09/2008
Last updated
03/23/2017
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