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General NPI Number Information
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NPI Number | 1730329475
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Entity Type | Organization
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Legal Business Name | B&B MEDICAL SPECIALTIES, INC.
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Dates
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Enumeration Date | 02/20/2009
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Last Update Date | 08/14/2009
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Provider Practice Location Address
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Address Line | 639 TEANECK RD
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City | TEANECK
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State | NJ
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Zip | 07666-4258
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Country | US
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Telephone | 973-423-9100
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Fax | 973-423-1339
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Provider Business Mailing Address
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Address Line | 219 LAFAYETTE AVE
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City | HAWTHORNE
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State | NJ
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Zip | 07506-1904
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Country | US
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Telephone | 973-423-9100
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT BERBERIAN
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Credential | MD
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Telephone | 201-446-3924
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MA083427
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License Number State | NJ
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