MEDICARE: DR. DONALD ARTHUR BERGMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	112384	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	298171	OTHER	NY	MEDICARE PROVIDER

General Provider Information

NPI Number	:	1013085596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD ARTHUR BERGMAN M.D.

Provider Business Mailing Address
First Line	:	1199 PARK AVE
Second Line	:	SUITE 1F
City	:	NEW YORK
State	:	NY
Zip	:	10128-1711
Country	:	US
Telephone Number	:	212-876-7333
Fax Number	:	212-876-5351

Provider Business Practice Location Address
First Line	:	1199 PARK AVE
Second Line	:	SUITE 1F
City	:	NEW YORK
State	:	NY
Zip	:	10128-1711
Country	:	US
Telephone Number	:	212-876-7333
Fax Number	:	212-876-5351

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	01/19/2023

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