Healthcare Provider Details

I. General information

NPI: 1639594377
Provider Name (Legal Business Name): BHMG - UNITED MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2014
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 RUTHERFORD AVE
LYNDHURST NJ
07071-1217
US

IV. Provider business mailing address

612 RUTHERFORD AVE
LYNDHURST NJ
07071-1217
US

V. Phone/Fax

Practice location:
  • Phone: 201-460-0063
  • Fax: 201-460-7195
Mailing address:
  • Phone: 201-460-0063
  • Fax: 201-460-7195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. GALINA M BEGUN
Title or Position: CREDENTIALING MANAGER
Credential: CPCS, CPMSM
Phone: 732-557-7119