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General NPI Number Information
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NPI Number | 1578714507
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Entity Type | Individual
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Provider Name | EBUBE A. BAKOSI M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/08/2008
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Last Update Date | 05/06/2015
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Provider Practice Location Address
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Address Line | 287 BOULEVARD SUITE 1
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-1726
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Country | US
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Telephone | 973-839-7400
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Fax | 973-831-4911
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Provider Business Mailing Address
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Address Line | PO BOX 416457
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City | BOSTON
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State | MA
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Zip | 02241-6457
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Country | US
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Telephone | 973-656-6280
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Fax | 973-290-7495
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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 | 204F00000X
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Taxonomy Name | Transplant Surgery Physician
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License Number | MD445723
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 25MA09042500
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD445723
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License Number State | PA
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