Healthcare Provider Details

I. General information

NPI: 1275506032
Provider Name (Legal Business Name): RONALD DAVID BERJU D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 05/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 OMNI DR
HILLSBOROUGH NJ
08844-4526
US

IV. Provider business mailing address

303 OMNI DR
HILLSBOROUGH NJ
08844-4526
US

V. Phone/Fax

Practice location:
  • Phone: 908-359-0123
  • Fax: 908-359-0143
Mailing address:
  • Phone: 908-359-0123
  • Fax: 908-359-0143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number38MC00275300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: