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NPI Code Detail

MEDICARE: THOMAS MICHAEL BERGES APN-C

MEDICARE: THOMAS MICHAEL BERGES APN-C
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
1363LA2200XAdult Health Nurse Practitioner26NO10786300NJ

General Provider Information

NPI Number : 1396959847
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS MICHAEL BERGES APN-C
Provider Business Mailing Address
First Line : 6 GRANDVIEW RD
Second Line :
City : CENTRAL VALLEY
State : NY
Zip : 10917-3724
Country : US
Telephone Number : 845-928-0680
Fax Number :
Provider Business Practice Location Address
First Line : 493 BLACK OAK RIDGE RD
Second Line :
City : WAYNE
State : NJ
Zip : 07470-6501
Country : US
Telephone Number : 973-692-5950
Fax Number : 973-646-7088
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2007
Last Update Date : 10/01/2024

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Directions to “ THOMAS MICHAEL BERGES APN-C” Practice Location

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