Berlin, Burgess L

Berlin, Burgess L is an sole proprietor health care provider with primary practice located at 125 Prospect Street , South Orange NJ 07079. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Berlin, Burgess L can be contacted via phone (973) 761-7755.

Contact Information

Primary practice address
125 Prospect Street South Orange NJ 07079
Phone: (973) 761-7755
Fax: (973) 761-6290
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 25 MA 0306 5300 New Jersey

Profile Details

NPI number 1740268655
LBN Legal business name Berlin, Burgess L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 3rd, 2006
Last updated Sep 10th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740268655 NPPES
Other 046172 MEDICARE
MEDICAID 3024601 MEDICARE

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