Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 48566 | NJ |
NPI | 1013181841 |
---|---|
Provider Name | Dr. Bruce Beckerman |
First Address | Manalapan, NJ 07726-9575 |
Second Address | Manalapan, NJ 07726-9575 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2008 |
Last Update Date | 14/04/2008 |