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General NPI Number Information
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NPI Number | 1790752426
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Entity Type | Organization
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Legal Business Name | BERGEN ORTHOPAEDIC SURGERY & SPORTS MEDICINE
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Dates
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Enumeration Date | 03/01/2006
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 235 CLOSTER DOCK ROAD
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City | CLOSTER
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State | NJ
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Zip | 07624-1947
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Country | US
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Telephone | 201-666-0013
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Fax | 877-547-5841
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Provider Business Mailing Address
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Address Line | 235 CLOSTER DOCK ROAD
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City | CLOSTER
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State | NJ
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Zip | 07624-1947
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Country | US
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Telephone | 201-666-0013
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Fax | 877-547-5841
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Authorized Official
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Title or Position | OWNER
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Name | ALAN MERVYN MILLER
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Credential | MD
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Telephone | 201-666-0013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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