Healthcare Provider Details

I. General information

NPI: 1356301477
Provider Name (Legal Business Name): JOEL BERMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 TOWNSHIP LINE ROAD SUITE 150
YARDLEY PA
19067-5567
US

IV. Provider business mailing address

PO BOX 102222
ATLANTA GA
30368-2222
US

V. Phone/Fax

Practice location:
  • Phone: 215-860-3360
  • Fax: 215-860-3362
Mailing address:
  • Phone: 239-274-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25MA12058600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME113323
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD044716L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier300118834
Identifier TypeOTHER
Identifier State
Identifier IssuerRAILROAD MEDICARE #
# 2
Identifier007393800
Identifier TypeMEDICAID
Identifier StateFL
Identifier Issuer
# 3
IdentifierP01126043
Identifier TypeOTHER
Identifier StateFL
Identifier IssuerRR MEDICARE
# 4
IdentifierP01126045
Identifier TypeOTHER
Identifier StateFL
Identifier IssuerRR MEDICARE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: