Healthcare Provider Details

I. General information

NPI: 1023180965
Provider Name (Legal Business Name): HARVEY S. WALDMAN, D.D.S. P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1024 PARK AVE SUITE 5
PLAINFIELD NJ
07060-3026
US

IV. Provider business mailing address

1024 PARK AVE SUITE 5
PLAINFIELD NJ
07060-3026
US

V. Phone/Fax

Practice location:
  • Phone: 908-757-6200
  • Fax: 908-757-0366
Mailing address:
  • Phone: 908-757-6200
  • Fax: 908-757-0366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number9797
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. MARVIN G WEISS
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 908-757-6200