Provider Demographics
NPI:1962591586
Name:BROMLEY, STEVEN M (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:M
Last Name:BROMLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:739 S. WHITE HORSE PIKE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:AUDUBON
Mailing Address - State:NJ
Mailing Address - Zip Code:08106-1659
Mailing Address - Country:US
Mailing Address - Phone:856-546-2300
Mailing Address - Fax:
Practice Address - Street 1:739 S. WHITE HORSE PIKE
Practice Address - Street 2:SUITE 1
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-1659
Practice Address - Country:US
Practice Address - Phone:856-546-2300
Practice Address - Fax:856-546-2301
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA075642002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1544360OtherAMERIHEALTH PPO/PABS
NJP00075059OtherRR MEDICARE
NJ60001043OtherHORIZON NJ HEALTH
NJ010005461OtherAMERICHOICE
NJ1544360OtherPA BS/ HIGHMARK
NJ41181OtherUNIVERISTY HEALTH PLAN
NJ7312160OtherCIGNA
NJ7513464OtherAETNA
NJ0016047Medicaid
NJ2228197000OtherAMERIHEALTH/KEYSTONE/IBC
NJ2373785OtherUNITED HEALTHCARE
NJP3017539OtherOXFORD
NJ2228197000OtherAMERIHEALTH/KEYSTONE/IBC
NJ073888Medicare PIN