Provider Demographics
NPI:1619068491
Name:OJSERKIS, BENNETT EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:BENNETT
Middle Name:EDWARD
Last Name:OJSERKIS
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 1:100 MEDICAL CENTER WAY
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2300
Mailing Address - Country:US
Mailing Address - Phone:609-653-3467
Mailing Address - Fax:609-653-3643
Practice Address - Street 1:100 MEDICAL CENTER WAY
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2300
Practice Address - Country:US
Practice Address - Phone:609-653-3467
Practice Address - Fax:609-653-3643
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04612900207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ379686OtherAMERIHEALTH
68763OtherAETNA
NJ1908502Medicaid
68763OtherAETNA
NJ1908502Medicaid