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Organization

LAWRENCE J BERMAN MD LLC

Active
Other names
Radburn Medical Associates
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARK ELLIOT WERTENTEIL M.D. (MANAGING PARTNER)
(201) 703-0202
Entity
Organization

Contact information

Practice address
20-20 FAIR LAWN AVE, FAIR LAWN, NJ 07410-2319
(201) 703-0202
(201) 703-1231
Mailing address
20-20 FAIR LAWN AVE, FAIR LAWN, NJ 07410-2319
(201) 703-0202
(201) 703-1231

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
087980
AETNA
NJ
05
8051208
NJ
Enumeration date
04/13/2006
Last updated
01/18/2008
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