| Bergen Medical Sports & Spine, Inc. | |
|
1 Sears Dr Third Floor Paramus NJ 07652-3515 | |
| (201) 261-5220 | |
| (201) 261-5223 |
| Full Name | Bergen Medical Sports & Spine, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 1 Sears Dr, Paramus, New Jersey |
| Authorized Official Name and Position | Gary Steven Herring (PRESIDENT) |
| Authorized Official Contact | 2018880021 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bergen Medical Sports & Spine, Inc. 131 Craig Rd Hillsdale NJ 07642-1054 Ph: (201) 888-0021 | Bergen Medical Sports & Spine, Inc. 1 Sears Dr Third Floor Paramus NJ 07652-3515 Ph: (201) 261-5220 |
| NPI Number | 1962722595 |
|---|---|
| Provider Enumeration Date | 06/05/2010 |
| Last Update Date | 06/05/2010 |
| Medicare PECOS PAC ID | 8022203033 |
|---|---|
| Medicare Enrollment ID | O20101116000078 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962722595 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | MA55527 (New Jersey) | Primary |
| Provider Name | Mimi A Chang |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1992718530 PECOS PAC ID: 9335114214 Enrollment ID: I20040908000016 |
| Provider Name | Robert Eisen |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1134222789 PECOS PAC ID: 9032152640 Enrollment ID: I20050606000189 |
| Provider Name | Gary S Herring |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669576187 PECOS PAC ID: 8325085855 Enrollment ID: I20090212000617 |
| Provider Name | Eun Choi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700140217 PECOS PAC ID: 1658522651 Enrollment ID: I20121126000396 |
| Provider Name | Elham Nasab |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1619236874 PECOS PAC ID: 9537394671 Enrollment ID: I20131028001009 |
| Provider Name | Andrea Flores |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1366889396 PECOS PAC ID: 3678708476 Enrollment ID: I20131104000417 |
| Provider Name | Danny J Gomez |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1174880603 PECOS PAC ID: 9133350077 Enrollment ID: I20140318001557 |
| Provider Name | Steven T Coachman |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1811041403 PECOS PAC ID: 9335369867 Enrollment ID: I20141006001513 |
| Provider Name | Lorenzo Luis Uy |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1487197331 PECOS PAC ID: 9335422724 Enrollment ID: I20170209000313 |
| Provider Name | Adam Wang |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093213266 PECOS PAC ID: 9133480635 Enrollment ID: I20180226000769 |
| Provider Name | Stephanie Ingrid B Gumban |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1609387000 PECOS PAC ID: 6204199920 Enrollment ID: I20180411001342 |
| Provider Name | Rachelle Mae S Ayonayon |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1982050654 PECOS PAC ID: 8729370879 Enrollment ID: I20231114002130 |
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