Provider Demographics
NPI:1528254810
Name:BERLIN MEDICAL ASSOCIATES - PA
Entity type:Organization
Organization Name:BERLIN MEDICAL ASSOCIATES - PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-767-0077
Mailing Address - Street 1:175 CROSS KEYS RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009-9263
Mailing Address - Country:US
Mailing Address - Phone:856-767-0077
Mailing Address - Fax:856-767-6102
Practice Address - Street 1:735 DAVISVILLE RD
Practice Address - Street 2:SUITE 2B
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-3276
Practice Address - Country:US
Practice Address - Phone:215-396-4227
Practice Address - Fax:215-354-4448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS002209L208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty