Provider Demographics
NPI:1629012521
Name:BERNA, WILLIAM JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:BERNA
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 1:509 SOUTH LENOLA ROAD
Mailing Address - Street 2:SUITE 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 SOUTH LENOLA ROAD
Practice Address - Street 2:SUITE 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
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA51798207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJBE592567Medicare ID - Type Unspecified
E53195Medicare UPIN