Provider Demographics
NPI:1063699189
Name:BERKLEY & KUSHEL PTRS
Entity type:Organization
Organization Name:BERKLEY & KUSHEL PTRS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:W
Authorized Official - Last Name:KUSHEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:609-588-4999
Mailing Address - Street 1:2083 KLOCKNER RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON SQUARE
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3415
Mailing Address - Country:US
Mailing Address - Phone:609-588-4999
Mailing Address - Fax:609-588-8186
Practice Address - Street 1:2083 KLOCKNER RD
Practice Address - Street 2:
Practice Address - City:HAMILTON SQUARE
Practice Address - State:NJ
Practice Address - Zip Code:08690-3415
Practice Address - Country:US
Practice Address - Phone:609-588-4999
Practice Address - Fax:609-588-8186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD01573213E00000X
NJ25MD001212213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA109793Medicare PIN
NJT44903Medicare UPIN
580222Medicare PIN
PAT44713Medicare UPIN
NJ416909Medicare PIN