Healthcare Provider Details

I. General information

NPI: 1386685006
Provider Name (Legal Business Name): KEREN EBEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 03/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 LAMINGTON RD
BEDMINSTER NJ
07921-2612
US

IV. Provider business mailing address

3322 ROUTE 22 BUILDING 10, SUITE 1002
BRANCHBURG NJ
08876-3476
US

V. Phone/Fax

Practice location:
  • Phone: 908-725-5530
  • Fax: 908-253-6559
Mailing address:
  • Phone: 908-725-5530
  • Fax: 908-253-6559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA07777900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: