Basic Information
| Provider Information | |||||||||
| NPI: | 1578714507 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAKOSI | ||||||||
| FirstName: | EBUBE | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 416457 | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 022416457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9736566280 | ||||||||
| FaxNumber: | 9732907495 | ||||||||
| Practice Location | |||||||||
| Address1: | 287 BOULEVARD | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | POMPTON PLAINS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 074441726 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9738397400 | ||||||||
| FaxNumber: | 9738314911 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/08/2008 | ||||||||
| LastUpdateDate: | 05/06/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 204F00000X | MD445723 | PA | N | Allopathic & Osteopathic Physicians | Transplant Surgery | 208600000X | 25MA09042500 | NJ | Y | Allopathic & Osteopathic Physicians | Surgery | 208600000X | MD445723 | PA | N | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.