Healthcare Provider Details

I. General information

NPI: 1346597200
Provider Name (Legal Business Name): DEREK BERBERIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DEREK BERBERIAN MD

II. Dates (important events)

Enumeration Date: 08/10/2012
Last Update Date: 03/23/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 N CENTRAL AVE
RAMSEY NJ
07446-1864
US

IV. Provider business mailing address

227 DONNY BROOK DR
ALLENDALE NJ
07401-1422
US

V. Phone/Fax

Practice location:
  • Phone: 201-588-3491
  • Fax: 201-357-4222
Mailing address:
  • Phone: 201-819-8545
  • Fax: 805-473-5931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA09655600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: