Provider Demographics
NPI:1093782302
Name:BECKMAN, HARVEY S (PHYSICIAN)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:S
Last Name:BECKMAN
Suffix:
Gender:M
Credentials:PHYSICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HAMBURG AVE
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:NJ
Mailing Address - Zip Code:07461
Mailing Address - Country:US
Mailing Address - Phone:973-875-3100
Mailing Address - Fax:973-875-3115
Practice Address - Street 1:2 HAMBURG AVE
Practice Address - Street 2:
Practice Address - City:SUSSEX
Practice Address - State:NJ
Practice Address - Zip Code:07461
Practice Address - Country:US
Practice Address - Phone:973-875-3100
Practice Address - Fax:973-875-3115
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA33107207RG0100X
NY147850207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0808903Medicaid
NJ1074397OtherHORIZON NJ HEALTH
NJOK3575OtherHEALTHNET
NJ0808903Medicaid
NJ009178Medicare ID - Type Unspecified