Individual
MIRO BERGAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
94 OLD SHORT HILLS RD, LIVINGSTON, NJ 07039-5672
(973) 322-5512
(973) 322-8165
Mailing address
25B VREELAND RD, SUITE 110, FLORHAM PARK, NJ 07932-1900
(973) 660-9334
(973) 660-9779
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA06868600
NJ
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
25MA06868600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7919409
—
NJ
Enumeration date
10/26/2006
Last updated
01/10/2011
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