Provider Demographics
NPI:1750447413
Name:BERGER, EUGENE JAMES (MSW)
Entity Type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:JAMES
Last Name:BERGER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 ALBERT RD
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07401-1002
Mailing Address - Country:US
Mailing Address - Phone:201-818-4186
Mailing Address - Fax:
Practice Address - Street 1:5 ALBERT RD
Practice Address - Street 2:
Practice Address - City:ALLENDALE
Practice Address - State:NJ
Practice Address - Zip Code:07401-1002
Practice Address - Country:US
Practice Address - Phone:201-818-4186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ002141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ00214OtherLCSW NJ