Organization
DIANNE W. BERESFORD, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANNE W BERESFORD MD (OWNER)
(973) 751-2240
Entity
Organization
Contact information
Practice address
303 BELMONT AVE, BELLEVILLE, NJ 07109-1103
(973) 751-2240
(973) 751-4886
Mailing address
303 BELMONT AVE, BELLEVILLE, NJ 07109-1103
(973) 751-2240
(973) 751-4886
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA04864500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1696009
—
NJ
Enumeration date
09/24/2013
Last updated
09/24/2013
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