Healthcare Provider Details

I. General information

NPI: 1346244282
Provider Name (Legal Business Name): PAUL J BERLIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 FRIES MILL RD STE A1
TURNERSVILLE NJ
08012-2015
US

IV. Provider business mailing address

188 FRIES MILL RD STE A1
TURNERSVILLE NJ
08012-2015
US

V. Phone/Fax

Practice location:
  • Phone: 856-262-9200
  • Fax: 856-728-6027
Mailing address:
  • Phone: 856-262-9200
  • Fax: 856-728-6027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number25MA05843000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: