Individual
KENNETH L. HERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
350 BOULEVARD, PASSAIC, NJ 07055-2840
(973) 365-5110
(973) 470-5944
Mailing address
307 S EVERGREEN AVE, WOODBURY, NJ 08096-2739
(856) 686-4300
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MB50008
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0647900
—
NJ
Enumeration date
06/09/2006
Last updated
07/12/2007
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