Healthcare Provider Details

I. General information

NPI: 1538149745
Provider Name (Legal Business Name): JESSICA BERLINER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 WELWYN PL
HENRICO VA
23229-8111
US

IV. Provider business mailing address

3 WELWYN PL
HENRICO VA
23229-8111
US

V. Phone/Fax

Practice location:
  • Phone: 804-363-8170
  • Fax: 804-282-3744
Mailing address:
  • Phone: 804-363-8170
  • Fax: 804-282-3744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberC135211
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number0101224789
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number0101224789
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number0101224789
License Number StateVA
# 5
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number102017
License Number StateGA
# 6
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101224789
License Number StateVA
# 7
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number0101224789
License Number StateVA
# 8
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number0101224789
License Number StateVA
# 9
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number0101224789
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: