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NPI Code Detail

MEDICARE: DR. JED BERMAN DDS

MEDICARE:  DR. JED  BERMAN  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
11223G0001XGeneral Practice Dentistry032631NY

General Provider Information

NPI Number : 1528161007
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JED BERMAN DDS
Provider Business Mailing Address
First Line : 163 CITY ISLAND AVE
Second Line :
City : BRONX
State : NY
Zip : 10464-1537
Country : US
Telephone Number : 718-885-1688
Fax Number : 718-885-9638
Provider Business Practice Location Address
First Line : 163 CITY ISLAND AVE
Second Line :
City : BRONX
State : NY
Zip : 10464-1537
Country : US
Telephone Number : 718-885-1688
Fax Number : 718-885-9638
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2006
Last Update Date : 07/08/2007

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Directions to “ DR. JED BERMAN DDS” Practice Location

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