Healthcare Provider Details

I. General information

NPI: 1902876055
Provider Name (Legal Business Name): SONDRA K BERGER DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SONDRA BERGER DARVIN

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 01/05/2021
Certification Date: 12/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 PINE WEST PLZ STE 306
ALBANY NY
12205-5522
US

IV. Provider business mailing address

3 PINE WEST PLZ STE 306
ALBANY NY
12205-5522
US

V. Phone/Fax

Practice location:
  • Phone: 518-456-3668
  • Fax:
Mailing address:
  • Phone: 518-456-3668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number005963
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number005963
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: