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General NPI Number Information
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NPI Number | 1467062463
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Entity Type | Individual
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Provider Name | ERICA JOSEPHINE LOBUGLIO PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/04/2020
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Last Update Date | 09/03/2020
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Provider Practice Location Address
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Address Line | 733 N BEERS ST STE U3
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City | HOLMDEL
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State | NJ
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Zip | 07733-1513
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Country | US
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Telephone | 732-556-8095
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Fax |
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Provider Business Mailing Address
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Address Line | 68 FURMAN AVE
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City | SAYREVILLE
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State | NJ
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Zip | 08872-1711
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Country | US
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Telephone | 732-556-8095
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 25MP00573000
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License Number State | NJ
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