MEDICARE: NEIL J BERGER DO

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	2085R0202X	Diagnostic Radiology Physician	0S003296L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	300064534	OTHER	PA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0065587001	OTHER	PA	AMERICHOICE
3	8322	OTHER	PA	BRAVO ELDER HEALTH
4	0057526000	OTHER	PA	INDEPENDENCE BLUE CROSS
5	15771	OTHER	PA	HEALTH PARTNERS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	1030343	OTHER	PA	KEYSTONE MERCY

General Provider Information

NPI Number	:	1376535997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEIL J BERGER DO

Provider Business Mailing Address
First Line	:	801 W GIRARD AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19122-4212
Country	:	US
Telephone Number	:	215-787-2000
Fax Number	:	215-787-2115

Provider Business Practice Location Address
First Line	:	1600 W GIRARD AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-1615
Country	:	US
Telephone Number	:	215-787-9000
Fax Number	:	215-787-2115

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

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	09/14/2019

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Directions to “ NEIL J BERGER DO” Practice Location

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