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General NPI Number Information
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NPI Number | 1144463365
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Entity Type | Organization
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Legal Business Name | STEPHEN BERCH MD PC
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Dates
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Enumeration Date | 04/17/2009
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Last Update Date | 04/17/2009
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Provider Practice Location Address
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Address Line | 211 FAIRVIEW AVE
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City | HUDSON
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State | NY
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Zip | 12534-1205
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Country | US
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Telephone | 518-828-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 211 FAIRVIEW AVE
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City | HUDSON
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State | NY
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Zip | 12534-1205
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Country | US
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Telephone | 518-828-2020
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEPHEN BERCH
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Credential | MD
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Telephone | 518-828-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 116766
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License Number State | NY
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