Provider Demographics
NPI:1023152980
Name:BERGEN HYPERTENSION & RENAL ASSOC
Entity type:Organization
Organization Name:BERGEN HYPERTENSION & RENAL ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:B
Authorized Official - Last Name:WEIZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-447-0013
Mailing Address - Street 1:1 KALISA WAY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652
Mailing Address - Country:US
Mailing Address - Phone:201-447-0013
Mailing Address - Fax:201-255-4515
Practice Address - Street 1:1 KALISA WAY
Practice Address - Street 2:SUITE 210
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652
Practice Address - Country:US
Practice Address - Phone:201-447-0013
Practice Address - Fax:201-255-4515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ526605Medicare PIN