Provider Demographics
NPI:1962731646
Name:BANDING CENTERS OF AMERICA AT FLORHAM PARK
Entity type:Organization
Organization Name:BANDING CENTERS OF AMERICA AT FLORHAM PARK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERTHA
Authorized Official - Suffix:
Authorized Official - Credentials:D,O
Authorized Official - Phone:973-261-1044
Mailing Address - Street 1:83 HANOVER RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1508
Mailing Address - Country:US
Mailing Address - Phone:973-805-9955
Mailing Address - Fax:973-805-9976
Practice Address - Street 1:83 HANOVER RD
Practice Address - Street 2:SUITE 160
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1508
Practice Address - Country:US
Practice Address - Phone:973-805-9955
Practice Address - Fax:973-805-9976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty