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NPI Code Detail

MEDICARE: DR. NORA V. BERGASA M.D.

MEDICARE: DR. NORA V. BERGASA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician164977-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396739553
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NORA V. BERGASA M.D.
Provider Business Mailing Address
First Line : 760 BROADWAY
Second Line : DEPARTMENT OF MEDICINE, 8TH FLOOR
City : BROOKLYN
State : NY
Zip : 11206
Country : US
Telephone Number : 718-963-5811
Fax Number :
Provider Business Practice Location Address
First Line : 760 BROADWAY
Second Line : SUBSPECIALTY CLINICS, HEPATOLOGY
City : BROOKLYN
State : NY
Zip : 11206-5317
Country : US
Telephone Number : 718-963-5811
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2005
Last Update Date : 07/08/2007

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