Healthcare Provider Details

I. General information

NPI: 1235790338
Provider Name (Legal Business Name): BERNARDS FAMILY PRACTICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2019
Last Update Date: 06/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 MARTINSVILLE RD STE 218
BASKING RIDGE NJ
07920-4700
US

IV. Provider business mailing address

665 MARTINSVILLE RD STE 218
BASKING RIDGE NJ
07920-4700
US

V. Phone/Fax

Practice location:
  • Phone: 908-607-1877
  • Fax: 908-607-1866
Mailing address:
  • Phone: 908-607-1877
  • Fax: 908-607-1866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH T. MORANDI
Title or Position: PHYSICIAN/OWNER
Credential: DO
Phone: 908-303-3779