1053473611 NPI number — DR. NOUREDDINE BERKA PH.D., D(ABHI)

Table of content: DR. NOUREDDINE BERKA PH.D., D(ABHI) (NPI 1053473611)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053473611 NPI number — DR. NOUREDDINE BERKA PH.D., D(ABHI)

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BERKA
Provider First Name:
NOUREDDINE
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D., D(ABHI)
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053473611
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
33 SIMCOE CIRCLE SW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CALGARY
Provider Business Mailing Address State Name:
ALBERTA
Provider Business Mailing Address Postal Code:
T3H4S6
Provider Business Mailing Address Country Code:
CA
Provider Business Mailing Address Telephone Number:
403-680-5355
Provider Business Mailing Address Fax Number:
403-685-5526

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2041 GEORGIA AVE NW
Provider Second Line Business Practice Location Address:
SUITE 4B39
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20060-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-865-4337
Provider Business Practice Location Address Fax Number:
202-865-4338
Provider Enumeration Date:
12/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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