Organization Active NPI

Bernard Henson

  • Surgery Physician
  • Wayne, NJ
National Provider Identifier
1710060314
Registry record updated Jul 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MA03972500 Issued in NJ
Legal business name
BERNARD HENSON
Practice address
220 Hamburg Tpke Ste 18a
Wayne, NJ 07470-2132
Phone
(973) 904-1704
Fax
(973) 595-8741
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2008

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

Authorized official

Name
Bernard Henson, MDNPI 1952331746
Title
Owner
Phone
(973) 904-1704

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X MA03972500 NJ Primary

Addresses

Primary practice location

220 Hamburg Tpke Ste 18a
Wayne, NJ 07470-2132

Mailing address

220 Hamburg Tpke Ste 18a
Wayne, NJ 07470-2132
Phone (973) 904-1704

Other identifiers 1

IdentifierTypeStateIssuer
3315207MedicaidNJ

National Provider Directory

National Provider Directory

Locations

220 Hamburg Tpke
Ste 18A
Wayne, NJ 07470
Phone (201) 904-1704

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1710060314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 HAMBURG TPKE STE 18A",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702132",
            "telephone_number": "973-904-1704",
            "fax_number": "973-595-8741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 HAMBURG TPKE STE 18A",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702132",
            "telephone_number": "973-904-1704",
            "fax_number": "973-595-8741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERNARD HENSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "HENSON",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-904-1704",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NJ",
            "license": "MA03972500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3315207",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.