Provider Demographics
NPI:1558544734
Name:NEIL H. DORFMAN, MD
Entity Type:Organization
Organization Name:NEIL H. DORFMAN, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:DORFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-753-9090
Mailing Address - Street 1:20 E TAUNTON RD
Mailing Address - Street 2:BLDG #2
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009-2603
Mailing Address - Country:US
Mailing Address - Phone:856-753-9090
Mailing Address - Fax:856-753-9001
Practice Address - Street 1:20 E TAUNTON RD
Practice Address - Street 2:BLDG #2
Practice Address - City:BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08009-2603
Practice Address - Country:US
Practice Address - Phone:856-753-9090
Practice Address - Fax:856-753-9001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA049170332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0174430001Medicare NSC