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General NPI Number Information
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NPI Number | 1316171671
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Entity Type | Organization
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Legal Business Name | BERLIN MEDICAL ASSCO
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Dates
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Enumeration Date | 05/14/2009
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Last Update Date | 05/14/2009
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Provider Practice Location Address
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Address Line | 175 CROSS KEYS RD 300A
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City | BERLIN
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State | NJ
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Zip | 08009-9263
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Country | US
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Telephone | 856-767-0077
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Fax | 856-767-6102
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Provider Business Mailing Address
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Address Line | 175 CROSS KEYS RD 300A
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City | BERLIN
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State | NJ
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Zip | 08009-9263
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Country | US
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Telephone | 856-767-0077
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Fax | 856-767-6102
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID HASSMAN
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Credential | DO
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Telephone | 856-767-0077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 25MB03351700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 25MB63065
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MB5814600
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License Number State | NJ
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