Organization
SHELLEY BERSON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAGGIE CUELLO (BILLING DIRECTOR)
(201) 391-8282
Entity
Organization
Contact information
Practice address
305 W GRAND AVE, SUITE 500, MONTVALE, NJ 07645-1813
(201) 391-8282
(201) 391-8299
Mailing address
305 W GRAND AVE, SUITE 500, MONTVALE, NJ 07645-1813
(201) 391-8282
(201) 391-8299
Taxonomy
Speciality
Code
Description
License number
State
173F00000X
Sleep Specialist (PhD)
Primary
25MA05783000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689927105
INDIVIDUAL NPI
—
Enumeration date
10/16/2013
Last updated
10/16/2013
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