Provider Demographics
NPI:1124376181
Name:BERGEN TOTAL HEALTH LLC
Entity Type:Organization
Organization Name:BERGEN TOTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPIONE
Authorized Official - Suffix:
Authorized Official - Credentials:APN-C, DC
Authorized Official - Phone:201-569-0500
Mailing Address - Street 1:135 COUNTY RD
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:CRESSKILL
Mailing Address - State:NJ
Mailing Address - Zip Code:07626-2203
Mailing Address - Country:US
Mailing Address - Phone:201-569-0500
Mailing Address - Fax:201-569-5561
Practice Address - Street 1:135 COUNTY RD STE 2A
Practice Address - Street 2:
Practice Address - City:CRESSKILL
Practice Address - State:NJ
Practice Address - Zip Code:07626
Practice Address - Country:US
Practice Address - Phone:201-290-5002
Practice Address - Fax:201-569-0500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-24
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00524400111NN0400X
NJ26NJ00816800363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
No111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty