Provider Demographics
NPI:1164730081
Name:HUNTERDON INTEGRATIVE PHYSICIANS
Entity Type:Organization
Organization Name:HUNTERDON INTEGRATIVE PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:BERK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-537-9191
Mailing Address - Street 1:415 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-4411
Mailing Address - Country:US
Mailing Address - Phone:570-208-5534
Mailing Address - Fax:570-208-5556
Practice Address - Street 1:33B RUPELL RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08827-4017
Practice Address - Country:US
Practice Address - Phone:908-537-9191
Practice Address - Fax:908-537-9187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA06947200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH01338Medicare UPIN
NJ029878Medicare PIN