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General NPI Number Information
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NPI Number | 1710982327
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Entity Type | Individual
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Provider Name | ANDREW MARK BERLINER DPM
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Gender | Male
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Dates
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Enumeration Date | 06/20/2005
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Last Update Date | 10/08/2010
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Provider Practice Location Address
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Address Line | 246 E MAIN ST SUITE 2
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City | CLINTON
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State | CT
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Zip | 06413-2245
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Country | US
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Telephone | 860-669-1320
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Fax |
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Provider Business Mailing Address
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Address Line | 7 LIBERTY VILLAGE
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City | CLINTON
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State | CT
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Zip | 06413
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Country | US
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Telephone | 860-669-4304
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | P00012
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License Number State | CT
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