Provider Demographics
NPI:1902998727
Name:BERMAN, DEAN ADAM (DO)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:ADAM
Last Name:BERMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HORNBEAM LN
Mailing Address - Street 2:
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-2443
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25 POCONO RD
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2954
Practice Address - Country:US
Practice Address - Phone:973-989-3396
Practice Address - Fax:973-989-3092
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07187600207P00000X
AZ006367207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8608300Medicaid
NJPAR AOtherBLUE SHIELD
NJPAR AOtherBLUE SHIELD
NJ8608300Medicaid
NJH15127Medicare UPIN
930118077Medicare PIN
NJ050990Medicare PIN