Berdy, Jack M

Berdy, Jack M is an individual health care provider with primary practice located at 155 Cedar Ln , Teaneck NJ 07666-4301. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Berdy, Jack M can be contacted via phone (201) 836-4248.

Contact Information

Primary practice address
155 Cedar Ln Teaneck NJ 07666-4301
Phone: (201) 836-4248
Fax: (201) 836-5420
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MA60816 New Jersey

Profile Details

NPI number 1215999115
LBN Legal business name Berdy, Jack M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2006
Last updated May 14th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215999115 NPPES
New Jersey Other 0853523000 AMERIHEALTH#
New Jersey Other P00332714 AMERIHEALTH#
New Jersey Other 0125870 AMERIHEALTH#
New Jersey Other 3K3825 AMERIHEALTH#
New Jersey Other 0479230 AMERIHEALTH#
New Jersey Other 230SB2 AMERIHEALTH#
New Jersey MEDICAID 6925201 AMERIHEALTH#
New Jersey Other P3688668 AMERIHEALTH#
New Jersey Other 0479230 AMERIHEALTH#

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