Individual
MRS. INGA BUFANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1075 CENTRAL AVE, CLARK, NJ 07066-1116
(732) 574-1399
(732) 574-1433
Mailing address
469 MORRIS AVE STE 3, ELIZABETH, NJ 07208-2904
(732) 574-1399
(732) 574-1433
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
010967
NY
363AS0400X
Surgical Physician Assistant
Primary
MP001871
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
179997
MEDICARE PTAN
NJ
Enumeration date
06/23/2006
Last updated
08/12/2020
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