Healthcare Provider Details

I. General information

NPI: 1093782302
Provider Name (Legal Business Name): HARVEY S BECKMAN PHYSICIAN
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 HAMBURG AVE
SUSSEX NJ
07461
US

IV. Provider business mailing address

2 HAMBURG AVE
SUSSEX NJ
07461
US

V. Phone/Fax

Practice location:
  • Phone: 973-875-3100
  • Fax: 973-875-3115
Mailing address:
  • Phone: 973-875-3100
  • Fax: 973-875-3115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMA33107
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number147850
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: