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General NPI Number Information
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NPI Number | 1174859318
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Entity Type | Organization
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Legal Business Name | EUGENE M.J. PUGATCH, M.D., P.A.
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Dates
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Enumeration Date | 10/22/2009
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Last Update Date | 10/22/2009
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Provider Practice Location Address
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Address Line | 4 CRESTVIEW CT
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City | MONTCLAIR
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State | NJ
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Zip | 07042-1702
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Country | US
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Telephone | 973-783-6811
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Fax | 973-783-7748
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Provider Business Mailing Address
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Address Line | 4 CRESTVIEW CT
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City | MONTCLAIR
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State | NJ
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Zip | 07042-1702
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Country | US
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Telephone | 973-783-6811
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Fax | 973-783-7748
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Authorized Official
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Title or Position | OWNER
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Name | DR. EUGENE M.J. PUGATCH
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Credential | M.D.
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Telephone | 973-783-6811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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