Individual
DR. JACK M BERDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
155 CEDAR LN, TEANECK, NJ 07666-4301
(201) 836-4248
(201) 836-5420
Mailing address
155 CEDAR LN, TEANECK, NJ 07666-4301
(201) 836-4248
(201) 836-5420
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA60816
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0125870
GHI PPO#
NJ
01
—
0479230
AETNA HMO #
NJ
01
—
0479230
AETNA PPO#
NY
01
—
0853523000
AMERIHEALTH#
NJ
01
—
230SB2
EMPIRE BC/BS #
NJ
01
—
3K3825
HEALTHNET#
NJ
05
—
6925201
—
NJ
01
—
P00332714
RAILROAD MEDICARE #
NJ
01
—
P3688668
OXFORD #
NJ
Enumeration date
04/05/2006
Last updated
05/14/2008
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