Provider Demographics
NPI:1356317028
Name:BEKELE, WONDWESSEN (MD)
Entity Type:Individual
Prefix:DR
First Name:WONDWESSEN
Middle Name:
Last Name:BEKELE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10 GLUTTING PL
Mailing Address - Street 2:
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-3055
Mailing Address - Country:US
Mailing Address - Phone:973-926-7161
Mailing Address - Fax:973-282-0395
Practice Address - Street 1:201 LYONS AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2027
Practice Address - Country:US
Practice Address - Phone:973-926-7161
Practice Address - Fax:973-282-0395
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA360652080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology