Provider Demographics
NPI:1942360664
Name:BECKER, ROBERT J (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:BECKER
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 1:1501 GATES CT
Mailing Address - Street 2:
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-3462
Mailing Address - Country:US
Mailing Address - Phone:414-793-5454
Mailing Address - Fax:
Practice Address - Street 1:59 KOCH RD
Practice Address - Street 2:GREYSTONE PARK PSYCHIATRIC HOSPITAL
Practice Address - City:MORRIS PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07950
Practice Address - Country:US
Practice Address - Phone:973-538-1800
Practice Address - Fax:973-889-8789
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA040247002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ176533C2EOtherMEDICARE BILLING NO.
NJBE176533Medicare PIN
NJ176533C2EOtherMEDICARE BILLING NO.