Provider Demographics
NPI:1154476851
Name:BERNARDS FAMILY PRACTICE
Entity Type:Organization
Organization Name:BERNARDS FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MORANDI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:908-607-1877
Mailing Address - Street 1:665 MARTINSVILLE RD
Mailing Address - Street 2:SUITE 218
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-4700
Mailing Address - Country:US
Mailing Address - Phone:908-607-1877
Mailing Address - Fax:
Practice Address - Street 1:665 MARTINSVILLE RD
Practice Address - Street 2:SUITE 218
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-4700
Practice Address - Country:US
Practice Address - Phone:908-607-1877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB62564207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG38352Medicare UPIN