Individual provider · NPI-1

James T Bergen, PA-C

Physician Assistant, Medical · Camden, NJ

NPI number1104914712
StatusActive
Last updated in NPPESSep 24, 2010

Details

NPI
1104914712
Entity type
Individual (NPI-1)
Name
Mr. James T Bergen
Credential
PA-C
Sex
Male
Sole proprietor
No
Enumeration date
Oct 10, 2006
Last updated
Sep 24, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363AM0700X Physician Assistant, MedicalMP00106NJYes

Practice location

3 Cooper Plz
Suite 311
Camden, NJ 08103-1438

Phone 856-342-2034 · Fax 856-342-6608

Mailing address

1 Cooper Plz
3 Dorrance
Camden, NJ 08103-1461

Phone 856-342-2034 · Fax 856-342-6608

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