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NPI Code Detail

MEDICARE: MR. PATRICK PAUL BERGMANN MS,CCC

MEDICARE: MR. PATRICK PAUL BERGMANN MS,CCC
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
1231H00000XAudiologist002039NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110102164OTHERNYCDPHP
250802000004OTHERNYFIDELAS
34899688OTHERNYGHI-PPO

General Provider Information

NPI Number : 1184620502
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PATRICK PAUL BERGMANN MS,CCC
Provider Business Mailing Address
First Line : 48 THOMPSON HILL RD.
Second Line :
City : RENSSELAER
State : NY
Zip : 12144
Country : US
Telephone Number : 518-943-0591
Fax Number : 518-943-0591
Provider Business Practice Location Address
First Line : 9 W SAND LAKE RD
Second Line :
City : WYNANTSKILL
State : NY
Zip : 12198-7954
Country : US
Telephone Number : 518-690-2060
Fax Number : 518-690-7111
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 01/26/2022

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