Provider Demographics
NPI:1346300753
Name:BERGKNOFF, HUGH (MD)
Entity Type:Individual
Prefix:
First Name:HUGH
Middle Name:
Last Name:BERGKNOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 N THIRD AVENUE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904
Mailing Address - Country:US
Mailing Address - Phone:732-846-0366
Mailing Address - Fax:
Practice Address - Street 1:4575 RTE 27
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:08528
Practice Address - Country:US
Practice Address - Phone:609-683-7979
Practice Address - Fax:609-683-1972
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA42496207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology