Healthcare Provider Details

I. General information

NPI: 1528069697
Provider Name (Legal Business Name): LORINDA JEAN BERGER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 09/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

722 E BUTLER PIKE
AMBLER PA
19002-2310
US

IV. Provider business mailing address

722 E BUTLER PIKE
AMBLER PA
19002-2310
US

V. Phone/Fax

Practice location:
  • Phone: 215-643-7800
  • Fax: 215-654-1256
Mailing address:
  • Phone: 215-643-7800
  • Fax: 215-654-1256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberOS 007648L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: