Bergen Internal Medicine LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MA54263 Issued in NJ

Legal business name

BERGEN INTERNAL MEDICINE LLC

Practice address

6 Horizon Rd
Fort Lee, NJ 07024-6652

Phone

(201) 886-8989

Fax

(201) 886-8990

NPI assigned

May 4, 2009

Last updated

Oct 17, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Richard Justin Gallo, MD

Title

President

Phone

(201) 886-8989

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Lam, MD

  • Internal Medicine Physician
  • Fort Lee, NJ
  • NPI 1184656050
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1241395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413504000000",
    "number": "1336373539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HORIZON RD",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246652",
            "telephone_number": "201-886-8989",
            "fax_number": "201-886-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 HORIZON RD",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246652",
            "telephone_number": "201-886-8989",
            "fax_number": "201-886-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGEN INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-04",
        "last_updated": "2014-10-17",
        "status": "A",
        "authorized_official_last_name": "GALLO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "JUSTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-886-8989",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA54263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4992806",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louis Frank Bellotti, DMD
• Hany W Benjamin, RPH
• Igor Beregnoi, PHD, L.P.C
• Bergen Care Pharmacy Inc (Bergen Care Pharmacy)
• Bergen Foot & Ankle Group LLC
• Bergen Physical Therapy & Wellness, P.C.
• Bergen Physical Therapy, LLC
• Bergen Psychological Services, LLC
• Emile Tobias Berk, PH.D.
• Steven Bernstein, D.P.M

• Internal Medicine Physician in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.