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NPI Code Detail

MEDICARE: MS. JANICE BERSOFF

MEDICARE: MS. JANICE BERSOFF
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
11041C0700XClinical Social WorkerI0000386OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10005451568OTHEROHAETNA
200000064641OTHEROHANTHEM

General Provider Information

NPI Number : 1427049493
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JANICE BERSOFF
Provider Business Mailing Address
First Line : 210 N MAIN ST
Second Line :
City : LONDON
State : OH
Zip : 43140-1115
Country : US
Telephone Number : 740-852-6256
Fax Number : 740-852-6395
Provider Business Practice Location Address
First Line : 210 N MAIN ST
Second Line :
City : LONDON
State : OH
Zip : 43140-1115
Country : US
Telephone Number : 740-852-6256
Fax Number : 740-852-6395
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2005
Last Update Date : 07/08/2007

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