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General NPI Number Information
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NPI Number | 1114988110
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Entity Type | Individual
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Provider Name | BERTIE MICHAEL BREGMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 535 W 110TH ST
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City | NEW YORK
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State | NY
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Zip | 10025-2086
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Country | US
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Telephone | 646-764-0025
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Fax | 646-682-9758
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Provider Business Mailing Address
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Address Line | 300 W 108TH ST APARTMENT 13B
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City | NEW YORK
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State | NY
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Zip | 10025-2757
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Country | US
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Telephone | 646-245-4448
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Fax | 646-682-9758
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 213539
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA11671800
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License Number State | NJ
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