Individual
DR. BERNARD J FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
216 ENGLE ST, SUITE 201, ENGLEWOOD, NJ 07631-2444
(201) 871-3414
(201) 871-4830
Mailing address
10 HIGH RIDGE RD, MONTVALE, NJ 07645-1550
(201) 930-1824
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
25MA02600200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1145506
NJ HEALTH
NJ
05
—
1995502
—
NJ
01
—
222258009
TAX ID
NJ
01
—
4255361
AETNA
NJ
01
—
441181946
RAILROAD MEDICARE
NJ
01
—
BS730
OXFORD
NJ
01
—
J31824
HEALTHNET
NJ
Enumeration date
01/02/2007
Last updated
06/29/2010
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