Individual
SANJA BUKARAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
20 BUCA RUN, PORTLAND, ME 04103-1427
(207) 749-6383
Mailing address
20 BUCA RUN, PORTLAND, ME 04103-1427
(207) 749-6383
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
015030
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015030
NEW YORK STATE LICENSE NUMBER
NY
Enumeration date
11/17/2014
Last updated
11/17/2014
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