Organization
INTERNAL MEDICINE ASSOCIATES OF BERGEN COUNTY P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY LYNN MILLER (PRACTICE ADMINISTRATOR)
(201) 487-3355
Entity
Organization
Contact information
Practice address
15 ANDERSON ST, HACKENSACK, NJ 07601-4508
(201) 487-3355
(201) 487-0960
Mailing address
15 ANDERSON ST, HACKENSACK, NJ 07601-4508
(201) 487-3355
(201) 487-0960
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
25MA07441900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
527229
MEDICARE PROVIDER #
NJ
Enumeration date
04/10/2008
Last updated
04/10/2008
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