ROBERT WOOD JOHNSON PHYSICIAN ENTERPRISE

Provider Demographics

• NPI: 1245587922
• Name: ROBERT WOOD JOHNSON PHYSICIAN ENTERPRISE
• Entity Type: Organization
• Organization Name: ROBERT WOOD JOHNSON PHYSICIAN ENTERPRISE
• Authorized Official - Title/Position: PRESIDENT & CEO
• Authorized Official - First Name: JOSHUA
• Authorized Official - Last Name: BERSHAD
• Authorized Official - Phone: 732-369-5994
• Mailing Address - Street 1: 3 EXECUTIVE DRIVE
• Mailing Address - Street 2: SUITE 400
• Mailing Address - City: SOMERSET
• Mailing Address - State: NJ
• Mailing Address - Zip Code: 08873
• Mailing Address - Country: US
• Mailing Address - Phone: 732-369-5994
• Mailing Address - Fax: 732-369-5993
• Practice Address - Street 1: 3 EXECUTIVE DRIVE
• Practice Address - Street 2: SUITE 400
• Practice Address - City: SOMERSET
• Practice Address - State: NJ
• Practice Address - Zip Code: 08873
• Practice Address - Country: US
• Practice Address - Phone: 732-369-5994
• Practice Address - Fax: 732-369-5993
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2012-08-13
• Last Update Date: 2017-05-08

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207Q00000X	Allopathic & Osteopathic Physicians	Family Medicine		Group - Multi-Specialty
No	207QS0010X	Allopathic & Osteopathic Physicians	Family Medicine	Sports Medicine	Group - Multi-Specialty
No	207R00000X	Allopathic & Osteopathic Physicians	Internal Medicine		Group - Multi-Specialty
No	207RC0000X	Allopathic & Osteopathic Physicians	Internal Medicine	Cardiovascular Disease	Group - Multi-Specialty
No	207RC0001X	Allopathic & Osteopathic Physicians	Internal Medicine	Clinical Cardiac Electrophysiology	Group - Multi-Specialty
No	207RC0200X	Allopathic & Osteopathic Physicians	Internal Medicine	Critical Care Medicine	Group - Multi-Specialty
No	207RG0100X	Allopathic & Osteopathic Physicians	Internal Medicine	Gastroenterology	Group - Multi-Specialty
No	207RG0300X	Allopathic & Osteopathic Physicians	Internal Medicine	Geriatric Medicine	Group - Multi-Specialty
No	207RP1001X	Allopathic & Osteopathic Physicians	Internal Medicine	Pulmonary Disease	Group - Multi-Specialty
No	207UN0901X	Allopathic & Osteopathic Physicians	Nuclear Medicine	Nuclear Cardiology	Group - Multi-Specialty
No	207V00000X	Allopathic & Osteopathic Physicians	Obstetrics & Gynecology		Group - Multi-Specialty
No	261QU0200X	Ambulatory Health Care Facilities	Clinic/Center	Urgent Care	Group - Multi-Specialty
No	363A00000X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant		Group - Multi-Specialty
No	363L00000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner		Group - Multi-Specialty
No	367A00000X	Physician Assistants & Advanced Practice Nursing Providers	Advanced Practice Midwife		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
NJ	0319392	Medicaid
NJ	0319392	Medicaid