Provider Demographics
NPI:1922665025
Name:BPS MEDICAL OF NEW JERSEY, LLC
Entity Type:Organization
Organization Name:BPS MEDICAL OF NEW JERSEY, LLC
Other - Org Name:BAYADA PHYSICIAN SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-406-0307
Mailing Address - Street 1:4300 HADDONFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-3376
Mailing Address - Country:US
Mailing Address - Phone:973-909-5159
Mailing Address - Fax:
Practice Address - Street 1:1 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-2429
Practice Address - Country:US
Practice Address - Phone:856-406-0307
Practice Address - Fax:856-406-0308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-23
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty