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General NPI Number Information
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NPI Number | 1174243216
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Entity Type | Individual
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Provider Name | ASHER BERKO
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Gender | Male
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Dates
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Enumeration Date | 08/30/2022
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Last Update Date | 08/30/2022
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Provider Practice Location Address
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Address Line | 50 CHESTNUT RIDGE RD STE 221
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City | MONTVALE
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State | NJ
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Zip | 07645-1814
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Country | US
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Telephone | 845-213-7423
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Fax |
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Provider Business Mailing Address
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Address Line | 50 CHESTNUT RIDGE RD STE 221
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City | MONTVALE
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State | NJ
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Zip | 07645-1814
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Country | US
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Telephone | 845-213-7423
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Fax |
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 31D2263993
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License Number State | NJ
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