Provider Demographics
NPI:1326182080
Name:BARBIERI COLAMEO & BERARDO ASSOC IN ORAL & MAXILLOFACIAL SURGERY PC
Entity Type:Organization
Organization Name:BARBIERI COLAMEO & BERARDO ASSOC IN ORAL & MAXILLOFACIAL SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:COLAMEO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-941-9494
Mailing Address - Street 1:605 BROAD AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07657-1604
Mailing Address - Country:US
Mailing Address - Phone:201-941-9494
Mailing Address - Fax:201-941-1246
Practice Address - Street 1:605 BROAD AVE STE 101
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07657-1604
Practice Address - Country:US
Practice Address - Phone:201-941-9494
Practice Address - Fax:201-941-1246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ33201223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ133914Medicare ID - Type Unspecified