| Colin A Bethel, MD | |
|
2130 Millburn Avenue, Suite C-1, Maplewood, NJ 07040 | |
| (888) 287-3652 | |
| (973) 549-6079 |
| Full Name | Colin A Bethel |
|---|---|
| Gender | Male |
| Speciality | Surgery - Pediatric Surgery |
| Location | 2130 Millburn Avenue, Maplewood, New Jersey |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871528943 | NPI | - | NPPES |
| 7346409 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2086S0120X | Surgery - Pediatric Surgery | 25MA06559800 (New Jersey) | Primary |
| Entity Name | Barnabas Health Medical Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1841557246 PECOS PAC ID: 9537316955 Enrollment ID: O20120820000951 |
| Entity Name | St Josephs Medical Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205425519 PECOS PAC ID: 8628470325 Enrollment ID: O20210716000520 |
| Mailing Address | Practice Location Address |
|---|---|
| Colin A Bethel, MD P.o. Box 785361, Pediatric Surgery Group, Philadelphia, PA 19178 Ph: (888) 282-3652 | Colin A Bethel, MD 2130 Millburn Avenue, Suite C-1, Maplewood, NJ 07040 Ph: (888) 287-3652 |
Nishith Bhattacharyya, MD Surgery Medicare: Medicare Enrolled Practice Location: 2130 Millburn Avenue, Pediatric Surgery Group, Maplewood, NJ 07040 Phone: 888-287-3652 Fax: 973-549-6079 | |
Dr. Michael Edward Valdes, MD Surgery Medicare: Medicare Enrolled Practice Location: 8 Fairview Ter, Maplewood, NJ 07040 Phone: 973-722-2747 Fax: 866-771-3575 |