Provider Demographics
NPI:1902855463
Name:DORFMAN, NEIL H (MD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:H
Last Name:DORFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:20 E TAUNTON RD
Mailing Address - Street 2:BLDG #2
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009-2603
Mailing Address - Country:US
Mailing Address - Phone:856-753-9090
Mailing Address - Fax:856-753-9001
Practice Address - Street 1:20 E TAUNTON RD
Practice Address - Street 2:BLDG #2
Practice Address - City:BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08009-2603
Practice Address - Country:US
Practice Address - Phone:856-753-9090
Practice Address - Fax:856-753-9001
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2010-06-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA0419170207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMA049170Medicaid
NJB41492Medicare UPIN
NJDO419236Medicare PIN