Healthcare Provider Details

I. General information

NPI: 1053645150
Provider Name (Legal Business Name): BERGEN HAND SPECIALISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2009
Last Update Date: 09/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 PROSPECT AVE SUITE #1
HACKENSACK NJ
07601-1960
US

IV. Provider business mailing address

25 PROSPECT AVE SUITE #1
HACKENSACK NJ
07601-1960
US

V. Phone/Fax

Practice location:
  • Phone: 201-880-4200
  • Fax: 201-880-4201
Mailing address:
  • Phone: 201-880-4200
  • Fax: 201-880-4201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number25MA08394500
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. ANGELA YLENIA GIUFFRIDA
Title or Position: OWNER
Credential: MD
Phone: 201-880-4200