Provider Demographics
NPI:1184879157
Name:WAYNE MEDICAL ASSOCIATES,P.A.
Entity type:Organization
Organization Name:WAYNE MEDICAL ASSOCIATES,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:BERKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-839-5070
Mailing Address - Street 1:2025 HAMBURG TPKE STE D
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-6250
Mailing Address - Country:US
Mailing Address - Phone:973-839-5070
Mailing Address - Fax:
Practice Address - Street 1:2025 HAMBURG TPKE STE D
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-6250
Practice Address - Country:US
Practice Address - Phone:973-839-5070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty