Provider Demographics
NPI:1265630180
Name:BERKEL, REYHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:REYHAN
Middle Name:
Last Name:BERKEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 BEECH ST
Mailing Address - Street 2:5C
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2114
Mailing Address - Country:US
Mailing Address - Phone:517-303-3120
Mailing Address - Fax:201-270-5112
Practice Address - Street 1:1300 MAIN AVE
Practice Address - Street 2:2A
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2266
Practice Address - Country:US
Practice Address - Phone:973-340-0160
Practice Address - Fax:201-270-5112
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2013-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08709600207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1245663277OtherGROUP NPI