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General NPI Number Information
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NPI Number | 1871569517
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Entity Type | Individual
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Provider Name | ELIZA BERKLEY MD
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Gender | Female
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 11/15/2021
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Provider Practice Location Address
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Address Line | 6433 ELEANOR CT
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City | NORFOLK
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State | VA
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Zip | 23508-1009
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Country | US
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Telephone | 704-685-2945
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 936
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City | NORFOLK
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State | VA
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Zip | 23501-0936
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Country | US
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Telephone | 757-573-6033
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Fax | 757-624-2254
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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 | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 20050184
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 0101241848
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License Number State | VA
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