Provider Demographics
NPI:1437369717
Name:JANET A ROBERTSON MD PA
Entity Type:Organization
Organization Name:JANET A ROBERTSON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-766-6110
Mailing Address - Street 1:169 MINE BROOK RD
Mailing Address - Street 2:
Mailing Address - City:BERNARDSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07924-2125
Mailing Address - Country:US
Mailing Address - Phone:908-766-6110
Mailing Address - Fax:908-766-0569
Practice Address - Street 1:169 MINE BROOK RD
Practice Address - Street 2:
Practice Address - City:BERNARDSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07924-2109
Practice Address - Country:US
Practice Address - Phone:908-766-6110
Practice Address - Fax:908-766-0569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04897400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1871649582OtherNPI (TYPE I ENTITY)
NJ571031Medicare PIN
NJE23791Medicare UPIN