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NPI Code Detail

MEDICARE: JONAS J BERMAN MD

MEDICARE: JONAS J BERMAN MD
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
12085R0202XDiagnostic Radiology Physician77059MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215931597
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONAS J BERMAN MD
Provider Business Mailing Address
First Line : 91 STILES RD
Second Line :
City : SALEM
State : NH
Zip : 03079-2846
Country : US
Telephone Number : 800-927-0002
Fax Number : 603-893-8886
Provider Business Practice Location Address
First Line : 295 VARNUM AVE
Second Line :
City : LOWELL
State : MA
Zip : 01854-2134
Country : US
Telephone Number : 978-937-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2005
Last Update Date : 07/08/2007

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