Individual
DR. JEAN BERGHAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1771 MADISON AVE, LAKEWOOD, NJ 08701-1251
(732) 364-2144
(732) 364-3559
Mailing address
1771 MADISON AVE, LAKEWOOD, NJ 08701-1251
(732) 364-2144
(732) 364-3559
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA070633
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8223203
—
NJ
Enumeration date
12/08/2006
Last updated
12/14/2012
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