Provider Demographics
NPI:1184826661
Name:BESSERMAN, EVA (DO)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:BESSERMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MUHLENBERG REGIONAL MEDICAL CENTER
Mailing Address - Street 2:PARK AVE. & RANDOLPH RD.
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07061
Mailing Address - Country:US
Mailing Address - Phone:908-668-2228
Mailing Address - Fax:908-226-4543
Practice Address - Street 1:MUHLENBERG REGIONAL MEDICAL CENTER
Practice Address - Street 2:PARK AVE. & RANDOLPH RD.
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07061
Practice Address - Country:US
Practice Address - Phone:908-668-2228
Practice Address - Fax:908-226-4543
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB05114000207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4561104Medicaid
NJE55347Medicare UPIN
NJ618202Medicare ID - Type Unspecified