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General NPI Number Information
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NPI Number | 1972524916
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Entity Type | Organization
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Legal Business Name | ROCKLAND EAR, NOSE, & THROAT ASSOC., P.C.
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 12/10/2007
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Provider Practice Location Address
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Address Line | 2 STRAWTOWN RD SUITES 6 & 7
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City | WEST NYACK
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State | NY
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Zip | 10994-1847
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Country | US
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Telephone | 845-727-1340
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Fax | 845-727-1349
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Provider Business Mailing Address
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Address Line | 2 STRAWTOWN RD SUITES 6 & 7
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City | WEST NYACK
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State | NY
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Zip | 10994-1847
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Country | US
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Telephone | 845-727-1340
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Fax | 845-727-1349
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHELLEY R. BERSON
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Credential | M.D.
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Telephone | 845-272-1340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 173585
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License Number State | NY
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