MEDICARE: BERGEN ORTHOPAEDIC SURGERY & SPORTS MEDICINE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician

General Provider Information

NPI Number	:	1790752426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BERGEN ORTHOPAEDIC SURGERY & SPORTS MEDICINE

Provider Business Mailing Address
First Line	:	235 CLOSTER DOCK ROAD
Second Line	:
City	:	CLOSTER
State	:	NJ
Zip	:	07624-1947
Country	:	US
Telephone Number	:	201-666-0013
Fax Number	:	877-547-5841

Provider Business Practice Location Address
First Line	:	235 CLOSTER DOCK ROAD
Second Line	:
City	:	CLOSTER
State	:	NJ
Zip	:	07624-1947
Country	:	US
Telephone Number	:	201-666-0013
Fax Number	:	877-547-5841

Authorized Official
Title or Position	:	OWNER
Name	:	ALAN MERVYN MILLER
Credential	:	MD
Telephone Number	:	201-666-0013

Provider Enumeration Date	:	03/01/2006
Last Update Date	:	11/04/2025

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