| Bergen Internal Medicine Llc | |
|
6 Horizon Rd Fort Lee NJ 07024-6652 | |
| (201) 886-8989 | |
| (201) 886-8990 |
| Full Name | Bergen Internal Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6 Horizon Rd, Fort Lee, New Jersey |
| Authorized Official Name and Position | Richard Justin Gallo (PRESIDENT) |
| Authorized Official Contact | 2018868989 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bergen Internal Medicine Llc 6 Horizon Rd Fort Lee NJ 07024-6652 Ph: (201) 886-8989 | Bergen Internal Medicine Llc 6 Horizon Rd Fort Lee NJ 07024-6652 Ph: (201) 886-8989 |
| NPI Number | 1336373539 |
|---|---|
| Provider Enumeration Date | 05/04/2009 |
| Last Update Date | 10/17/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336373539 | NPI | - | NPPES |
| 4992806 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MA54263 (New Jersey) | Primary |
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