Organization
BERGEN MEDICAL GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLAIR ALEXANDER BERGEN I M.D. (PRESIDENT)
(609) 484-1001
Entity
Organization
Contact information
Practice address
233 W ABSECON BLVD, ABSECON, NJ 08201-2403
(609) 484-1001
(609) 484-1004
Mailing address
26 WILSON DR, NORTHFIELD, NJ 08225-2569
(609) 484-1001
(609) 484-1004
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
25MA04675800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7850905
—
NJ
Enumeration date
01/22/2007
Last updated
08/22/2020
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