Provider Demographics
NPI:1205931797
Name:BROMLEY, WILLIAM H II (DO)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:BROMLEY
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:726 S WHITE HORSE PIKE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:AUDUBON
Mailing Address - State:NJ
Mailing Address - Zip Code:08106-1326
Mailing Address - Country:US
Mailing Address - Phone:856-546-6666
Mailing Address - Fax:856-546-5345
Practice Address - Street 1:726 S WHITE HORSE PIKE
Practice Address - Street 2:SUITE 2
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-1326
Practice Address - Country:US
Practice Address - Phone:856-546-6666
Practice Address - Fax:856-546-5345
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB05703800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF55966Medicare UPIN
NJ743523Medicare ID - Type Unspecified