1073598033 NPI number — DR. JEFFREY O. BERMAN MD

Table of content: MR. JAMES WALTER WOOLDRIDGE III CRNA (NPI 1437571262)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073598033 NPI number — DR. JEFFREY O. BERMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BERMAN
Provider First Name:
JEFFREY
Provider Middle Name:
O.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1073598033
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/16/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
210 WESTCHESTER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITE PLAINS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10604-2901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-681-3146
Provider Business Mailing Address Fax Number:
914-682-6403

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
210 WESTCHESTER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITE PLAINS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10604-2901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-682-6488
Provider Business Practice Location Address Fax Number:
914-682-6403
Provider Enumeration Date:
12/13/2005

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: 2084N0400X , with the licence number:  199287 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 130026394 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0004401952 . This is a "AETNA NON HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133884168 . This is a "EMPIRE STATE PLAN (NYS)" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133884168 . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7504468-007 . This is a "CIGNA SPECIALTY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P1884744 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2303863 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4C5579 . This is a "HEALTHE NET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133884168 . This is a "BEECH STREET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133884168 . This is a "HORIZON HEALTHCARE OF NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000074910 . This is a "GHI HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133884168 . This is a "MULTIPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133884168 . This is a "POMCO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3000841 . This is a "GHI PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133884168 . This is a "PHCS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 199287 . This is a "CONNECTICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2251863 . This is a "AETNA HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 59821 . This is a "BLUE CROSS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 199287-4-W . This is a "WORKERS COMPENSATION" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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