Provider Demographics
NPI:1013947092
Name:BERGEN & PASSAIC RESPIRATORY CARE, INC.
Entity Type:Organization
Organization Name:BERGEN & PASSAIC RESPIRATORY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANUTA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURON
Authorized Official - Suffix:X
Authorized Official - Credentials:
Authorized Official - Phone:973-773-7171
Mailing Address - Street 1:228 ROWLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012
Mailing Address - Country:US
Mailing Address - Phone:973-773-7171
Mailing Address - Fax:973-773-7115
Practice Address - Street 1:933 VAN HOUTEN AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013
Practice Address - Country:US
Practice Address - Phone:973-773-7171
Practice Address - Fax:973-773-7115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ01092146OtherAMERIGROUP OF NJ
NJ6891705Medicaid
NJ0966400001Medicare NSC