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General NPI Number Information
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NPI Number | 1710950639
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Entity Type | Individual
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Provider Name | PAMELA BRUG MD
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Gender | Female
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Dates
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Enumeration Date | 02/10/2006
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Last Update Date | 11/26/2013
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Provider Practice Location Address
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Address Line | RARITAN BAY MEDICAL CENTER - DEPT. OB&GYN 530 NEW BRUNSWICK AVE
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City | PERTH AMBOY
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State | NJ
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Zip | 08861
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Country | US
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Telephone | 732-324-6065
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Fax | 732-324-6063
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Provider Business Mailing Address
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Address Line | RARITAN BAY MEDICAL CENTER - DEPT. OB&GYN 530 NEW BRUNSWICK AVE
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City | PERTH AMBOY
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State | NJ
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Zip | 08861
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Country | US
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Telephone | 732-324-6065
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Fax | 732-324-6063
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MA058810
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License Number State | NJ
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