Provider Demographics
NPI:1417978495
Name:INTERNAL MEDICINE PHYSICIANS
Entity Type:Organization
Organization Name:INTERNAL MEDICINE PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-234-2722
Mailing Address - Street 1:509 S LENOLA RD
Mailing Address - Street 2:STE 3
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057
Mailing Address - Country:US
Mailing Address - Phone:856-234-2722
Mailing Address - Fax:856-234-7746
Practice Address - Street 1:509 S LENOLA RD
Practice Address - Street 2:STE 3
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057
Practice Address - Country:US
Practice Address - Phone:856-234-2722
Practice Address - Fax:856-234-7746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8054207Medicaid
NJ8054207Medicaid