Provider Demographics
NPI:1912039710
Name:BERGEN HUDSON ENT LLC
Entity Type:Organization
Organization Name:BERGEN HUDSON ENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BABAK
Authorized Official - Middle Name:
Authorized Official - Last Name:BEHIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-659-4706
Mailing Address - Street 1:142 PALISADE AVE
Mailing Address - Street 2:SUITE # 207
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-1133
Mailing Address - Country:US
Mailing Address - Phone:201-659-4706
Mailing Address - Fax:201-659-4707
Practice Address - Street 1:142 PALISADE AVE
Practice Address - Street 2:SUITE # 207
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1133
Practice Address - Country:US
Practice Address - Phone:201-659-4706
Practice Address - Fax:201-659-4707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ090834Medicare ID - Type Unspecified
NJI24092Medicare UPIN