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Individual

MAXIMO GABUCAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
530 NEW BRUNSWICK AVE, PERTH AMBOY, NJ 08861-3674
(732) 324-5348
(732) 324-4811
Mailing address
PO BOX 48270, NEWARK, NJ 07101-4800
(201) 818-9118

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25MA05696500
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
60013973
HORIZON NJ HEALTH #
NJ
01
8220016
GHI PPO #
NJ
01
P00207342
RR MDCR #
NJ
01
P3486545
OXFORD #
NJ
Enumeration date
06/02/2006
Last updated
04/16/2008
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