Healthcare Provider Details

I. General information

NPI: 1184826661
Provider Name (Legal Business Name): EVA BESSERMAN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MUHLENBERG REGIONAL MEDICAL CENTER PARK AVE. & RANDOLPH RD.
PLAINFIELD NJ
07061
US

IV. Provider business mailing address

MUHLENBERG REGIONAL MEDICAL CENTER PARK AVE. & RANDOLPH RD.
PLAINFIELD NJ
07061
US

V. Phone/Fax

Practice location:
  • Phone: 908-668-2228
  • Fax: 908-226-4543
Mailing address:
  • Phone: 908-668-2228
  • Fax: 908-226-4543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number25MB05114000
License Number StateNJ

VII. Legacy identifiers

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

# 1
Identifier4561104
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: