Provider Demographics
NPI:1255375374
Name:BERNHEIM, JOSHUA WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:WILLIAM
Last Name:BERNHEIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:83 WESTMINSTER AVE
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-3915
Mailing Address - Country:US
Mailing Address - Phone:201-244-5102
Mailing Address - Fax:201-444-8848
Practice Address - Street 1:1200 E RIDGEWOOD AVE
Practice Address - Street 2:WEST WING 2ND FLOOR
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3957
Practice Address - Country:US
Practice Address - Phone:201-444-5353
Practice Address - Fax:201-444-8848
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA077325002086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ082757Medicare ID - Type Unspecified