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General NPI Number Information
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NPI Number | 1215931597
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Entity Type | Individual
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Provider Name | JONAS J BERMAN MD
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Gender | Male
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Dates
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Enumeration Date | 06/02/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 295 VARNUM AVE
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City | LOWELL
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State | MA
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Zip | 01854-2134
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Country | US
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Telephone | 978-937-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 91 STILES RD
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City | SALEM
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State | NH
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Zip | 03079-2846
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Country | US
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Telephone | 800-927-0002
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Fax | 603-893-8886
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 77059
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License Number State | MA
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