Provider Demographics
NPI:1912113739
Name:BRETT A. GARBER, DO, LLC
Entity Type:Organization
Organization Name:BRETT A. GARBER, DO, LLC
Other - Org Name:GARBER PLASTIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARBER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:856-616-9200
Mailing Address - Street 1:1605 E EVESHAM RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-1421
Mailing Address - Country:US
Mailing Address - Phone:856-616-9200
Mailing Address - Fax:856-616-1100
Practice Address - Street 1:1605 E EVESHAM RD
Practice Address - Street 2:SUITE 201
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-1421
Practice Address - Country:US
Practice Address - Phone:856-616-9200
Practice Address - Fax:856-616-1100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB0720732086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2033057000OtherAMERIHEALTH
NJ1333139OtherBLUE CROSS BLUE SHIELD
NJ2033057000OtherKEYSTONE
NJ2680192OtherAETNA
NJ0099163Medicaid
NJ2033057000OtherKEYSTONE
NJ142261Medicare UPIN
NJ054140Medicare ID - Type Unspecified