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General NPI Number Information
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NPI Number | 1013924414
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Entity Type | Individual
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Provider Name | MARK BERMAN DMD
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 04/03/2012
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Provider Practice Location Address
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Address Line | 1 PARADIES LN HUDSON RIVER HEALTHCARE, INC.
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City | NEW PALTZ
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State | NY
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Zip | 12561-4031
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Country | US
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Telephone | 845-255-4290
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Fax | 845-255-4295
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Provider Business Mailing Address
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Address Line | 1037 MAIN ST HUDSON RIVER HEALTHCARE, INC.
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City | PEEKSKILL
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State | NY
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Zip | 10566-2913
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Country | US
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Telephone | 914-734-8800
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Fax | 914-734-8786
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 034244
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License Number State | NY
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