MEDICARE: MRS. NATALIYA BERGER DDS

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	1223G0001X	General Practice Dentistry	038037-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	9179219	OTHER	NY	DORAL DENTAL PLAN

General Provider Information

NPI Number	:	1508040957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NATALIYA BERGER DDS

Provider Business Mailing Address
First Line	:	2423 MERMAID AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-2256
Country	:	US
Telephone Number	:	718-373-0300
Fax Number	:	718-373-0570

Provider Business Practice Location Address
First Line	:	2423 MERMAID AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-2256
Country	:	US
Telephone Number	:	718-373-0300
Fax Number	:	718-373-0570

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

Provider Enumeration Date	:	12/20/2007
Last Update Date	:	12/20/2007

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